食道癌根治性治疗后在肿瘤学结果、手术并发症和健康相关生活质量方面的性别差异:多中心回顾性分析。

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-03-01 DOI:10.1093/bjsopen/zrae026
Styliani Mantziari, Jessie A Elliott, Sheraz R Markar, Fredrik Klevebro, Lucas Goense, Asif Johar, Pernilla Lagergren, Giovanni Zaninotto, Richard van Hillegersberg, Mark I van Berge Henegouwen, Markus Schäfer, Magnus Nilsson, George B Hanna, John V Reynolds
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引用次数: 0

摘要

背景:食道癌,尤其是腺癌,男性患者居多。然而,患者性别对手术和肿瘤治疗效果以及健康相关生活质量恢复的影响却鲜有记载,这也是这项大型多中心队列研究的重点:方法:对2009年至2015年期间在欧洲20个食管癌切除术后监测调查研究小组中心接受食管癌切除术的所有连续患者进行评估。对男性和女性患者的临床病理变量、治疗方法、术后并发症、存活率以及与健康相关的生活质量数据进行了比较。多变量分析对年龄、性别、肿瘤组织学、治疗方案和主要并发症进行了调整。对腺癌与鳞癌的所有主要结果进行了特定的亚组分析:共分析了 3974 例患者,其中男性 3083 例(77.6%),女性 891 例(22.4%);两组患者均以腺癌为主,而鳞癌在女性患者中更为常见(39.8% 对 15.1%,P < 0.001)。多变量分析显示,女性患者的总生存期(HRmales 1.24,95% c.i.1.07-1.44)和无病生存期(HRmales 1.22,95% c.i.1.05-1.43)均有所改善,这是腺癌亚组造成的,而鳞癌亚组的这一差异未得到证实。男性患者的健康相关生活质量功能评分较高,但出现经济问题的风险也较高,而女性患者的总体综合评分较低,且胃肠道症状更顽固:这项研究独特地揭示了女性性别与食道癌(尤其是腺癌)治愈性治疗后更有利的长期生存有关,尽管女性的长期总体生活质量和胃肠道健康相关生活质量更差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sex-related differences in oncologic outcomes, operative complications and health-related quality of life after curative-intent oesophageal cancer treatment: multicentre retrospective analysis.

Background: Oesophageal cancer, in particular adenocarcinoma, has a strong male predominance. However, the impact of patient sex on operative and oncologic outcomes and recovery of health-related quality of life is poorly documented, and was the focus of this large multicentre cohort study.

Methods: All consecutive patients who underwent oncological oesophagectomy from 2009 to 2015 in the 20 European iNvestigation of SUrveillance after Resection for Esophageal cancer study group centres were assessed. Clinicopathologic variables, therapeutic approach, postoperative complications, survival and health-related quality of life data were compared between male and female patients. Multivariable analyses adjusted for age, sex, tumour histology, treatment protocol and major complications. Specific subgroup analyses comparing adenocarcinoma versus squamous cell cancer for all key outcomes were performed.

Results: Overall, 3974 patients were analysed, 3083 (77.6%) male and 891 (22.4%) female; adenocarcinoma was predominant in both groups, while squamous cell cancer was observed more commonly in female patients (39.8% versus 15.1%, P < 0.001). Multivariable analysis demonstrated improved outcomes in female patients for overall survival (HRmales 1.24, 95% c.i. 1.07 to 1.44) and disease-free survival (HRmales 1.22, 95% c.i. 1.05 to 1.43), which was caused by the adenocarcinoma subgroup, whereas this difference was not confirmed in squamous cell cancer. Male patients presented higher health-related quality of life functional scores but also a higher risk of financial problems, while female patients had lower overall summary scores and more persistent gastrointestinal symptoms.

Conclusion: This study reveals uniquely that female sex is associated with more favourable long-term survival after curative treatment for oesophageal cancer, especially adenocarcinoma, although long-term overall and gastrointestinal health-related quality of life are poorer in women.

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BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
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