Can early diagnosis of symptomatic colorectal cancer improve the prognosis?
Can early diagnosis of symptomatic colorectal cancer improve the prognosis?
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DOI：
10.1007/s00268-004-7232-8
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发表时间：
2004-07-01
影响因子：
2.6
通讯作者：
Medina-Arana, V
中科院分区：
文献类型：
--
作者：
Gonzalez-Hermoso, F;Perez-Palma, J;Medina-Arana, V
结直肠癌患者持续出现相对晚期的肿瘤。诊断延误通常被认为是一个促成因素，这一假设的有效性很少受到质疑。本研究的目的是确定诊断延迟是否与长期生存有关，以及最常见的症状是否与癌症诊断的阶段或时间有关。本文回顾性分析了1985年至2000年间我院接受手术治疗的660例无并发症结直肠癌患者的资料。年龄、性别、初始症状、症状持续时间、肿瘤位置、治疗性手术、TNM分期和生存时间是记录的变量。根据症状持续时间分为两组：3个月。对两组患者的初始症状、TNM分期、生存时间进行比较统计分析。此外，最常报告的初始症状与TNM阶段进行了比较。研究发现，两组患者在年龄、性别、肿瘤位置、手术类型和TNM分期的分布方面是相同的。我们发现腹痛时症状持续时间缩短（p=0.002）[优势比（OR） 0.53；95%可信区间（CI） 0.35-0.80)，并在存在贫血综合征时延迟（p=0.006） （OR 2.4; 95% CI 1.27-4.56）。此外，肿瘤的分期与直肠出血有关
Patients with colorectal cancer continue to present with relatively advanced tumors. Delay in diagnosis is often believed to have been a contributing factor, and the validity of this hypothesis has seldom been questioned. The aim of this study was to establish whether a delay in diagnosis is related to long-term survival and if the most frequent symptoms were related to the stage or time at which the carcinoma was diagnosed. Data from 660 patients surgically treated for uncomplicated colorectal carcinoma in our institution between 1985 and 2000 were analyzed retrospectively. Age, sex, initial symptoms, duration of symptoms, neoplasm location, curative surgery, TNM stage, and survival time were the variables recorded. Patients were classified into two groups according to symptom duration: 3 months. Comparative statistical analysis was performed for the two groups as well as the initial symptom, TNM stage, and survival time. Also, the initial symptoms most frequently reported were compared with the TNM stage. The two groups were found to be equal with regard to distribution of age, gender, location of the neoplasm, type of surgery performed, and TNM stage. We found that symptom duration was shortened in the presence of abdominal pain (p=0.002) [odds ratio (OR) 0.53; 95% confidence interval (CI) 0.35-0.80] and was delayed in the presence of an anemic syndrome (p=0.006) (OR 2.4; 95% CI 1.27-4.56). Also, the stage of the neoplasm was related to rectal bleeding (p