Improved survival after an educational project on colon cancer management in the county of Stockholm - A population based cohort study
Improved survival after an educational project on colon cancer management in the county of Stockholm - A population based cohort study
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DOI：
10.1016/j.ejso.2015.07.019
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发表时间：
2015-11-01
期刊：
影响因子：
3.8
通讯作者：
Holm, T.
中科院分区：
文献类型：
--
作者：
Bernhoff, R.;Martling, A.;Holm, T.
导读：采用全肠系膜切除术（TME）后，直肠癌的预后显著改善。最近，为了改善结肠癌患者的预后，TME的概念已经转变为完全肠系膜切除（CME）的概念。患者和方法：2004年至2008年，每年在卡罗林斯卡大学医院举行多学科小组（MDT）研讨会，包括CME概念。研讨会的重点是术前分期、手术和组织病理学，并包括讲座和现场手术。为了比较“斯德哥尔摩结肠癌项目”前后的生存率，2001年1月1日至2003年12月31日（第一组）和2006年1月1日至2008年12月31日（第二组）在斯德哥尔摩诊断为右侧结肠癌的所有患者从瑞典结直肠癌登记处（SCRCR）中确定。结果：1组患者行肿瘤切除术及急诊手术的比例较高。2组早期肿瘤较多，R0切除较多。所有确诊患者的总生存率和肿瘤切除后的无病生存率在第二期得到改善。讨论：外科教学方案可能对结肠癌的治疗和预后有影响。“斯德哥尔摩结肠癌项目”的确切影响还不能确定，但它很可能有助于提高生存率。(C) 2015 Elsevier Ltd.版权所有。
Introduction: Outcomes in rectal cancer have improved dramatically after the introduction of total mesorectal excision (TME). Recently, the TME concept has been transformed into that of complete mesocolic excision (CME) in an attempt to improve prognosis for patients with colon cancer.Patients and methods: Multidisciplinary team (MDT) workshops including the CME concept were held annually between 2004 and 2008 at the Karolinska University Hospital. The workshops focused on preoperative staging, surgery and histopathology and included lectures and live surgery sessions. To compare survival before and after the "Stockholm Colon Cancer Project" all patients diagnosed with a right sided colon cancer between January 1, 2001 and December 31, 2003 (Group 1) and from January 1, 2006 until December 31, 2008 (Group 2) in Stockholm were identified from the Swedish ColoRectal Cancer Registry (SCRCR).Results: The proportion of patients having a tumour resection and the proportion having emergency surgery was higher in Group 1. There were more early tumours and more R0 resections in Group 2. Overall survival in all diagnosed patients and disease free survival after tumour resection was improved in the second time period.Discussion: Surgical teaching programmes may have an impact on the management and outcome in colon cancer. The exact impact from the "Stockholm Colon Cancer Project" cannot be established, however it is likely that it contributed to the improved survival. (C) 2015 Elsevier Ltd. All rights reserved.