Intraoperative blood loss independently predicts survival and recurrence after resection of colorectal cancer liver metastasis.
Intraoperative blood loss independently predicts survival and recurrence after resection of colorectal cancer liver metastasis.
复制标题
DOI：
10.1371/journal.pone.0076125
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
De-Sen Wan
中科院分区：
文献类型：
--
作者：
Jiang W;Fang YJ;Wu XJ;Wang FL;Lu ZH;Zhang RX;Ding PR;Fan WH;Pan ZZ;De-Sen Wan
尽管结直肠癌肝转移(CRLM)的预后因素已有众多报道，但很少有研究报道术中失血(IBL)对CRLM切除后临床预后的影响。我们回顾了139例接受肝切除的CRLM患者的临床和组织病理学特征。使用接收器工作特性曲线计算IBL截止体积。总生存率(OS)和无复发生存率(RFS)采用Kaplan-Meier和Cox回归分析方法。所有患者均行根治性切除。中位随访期为25.0个月(2.1~88.8)。体重指数(BMI)、CRLM数目和肿瘤大小与IBL增加相关。BMI(P=0.01；95%CI=1.3-8.5)和IBL(P<；0.01；95%CI=1.6-12.5)是OSOS的独立预测因素。多因素COX回归分析显示，IBL(P=0.02；95%CI=1.1~4.1)等5个因素与RFS显著相关。此外，随着IBL容量的增加，OSOS和RFS显著减少。≤为2 5 0、2 5 0~5 0 0和5 0 0ml的患者5年OSO分别为71%、33%和0%(P<；0.0 1)。第一年末，三个IBL体积内的患者的RFS分别为67%、38%和18%(P<；0.01)。CRLM切除术中的IBL是长期生存和肿瘤复发的独立预测因子，其预后价值通过剂量-反应关系得到证实。
Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM), few studies have reported intraoperative blood loss (IBL) effects on clinical outcome after CRLM resection. We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS) and recurrence free survival (RFS) were assessed using the Kaplan–Meier and Cox regression methods. All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1–88.8). Body mass index (BMI) and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3–8.5) and IBL (P<0.01; 95% CI = 1.6–12.5) were independent OSOs predictors. Five factors, including IBL (P=0.02; 95% CI = 1.1–4.1), were significantly related to RFS via multivariate Cox regression analysis. In addition, OSOs and RFS significantly decreased with increasing IBL volumes. The 5-year OSOs of patients with IBL≤250, 250–500, and >500mL were 71%, 33%, and 0%, respectively (P<0.01). RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01). IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose–response relationship.
登录
查看更多内容
影响因子：
4.3
作者：
Qiu, Hai-Bo;Zhang, Li-Yi;Xu, Rui-Hua
通讯作者：
Xu, Rui-Hua
影响因子：
9
作者：
TARTTER, PI
通讯作者：
TARTTER, PI
影响因子：
158.5
作者：
BUSCH, ORC;HOP, WCJ;JEEKEL, J
通讯作者：
JEEKEL, J
影响因子：
2.6
作者：
Achavanuntakul, Kajohn;Charoenkwan, Kittipat
通讯作者：
Charoenkwan, Kittipat
影响因子：
45.3
作者：
Tomlinson, James S.;Jarnagin, William R.;D'Angelica, Michael
通讯作者：
D'Angelica, Michael