与诊断相关的华法林摄入量可降低结直肠癌患者的死亡率--一项基于登记的研究。

Q3 Medicine
Anders S. Eriksson , Henry Eriksson , Per-Olof Hansson , Kurt Svärdsudd
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引用次数: 0

摘要

背景:多项研究分析了抗凝剂对癌症生存率的影响,结果各不相同。本研究旨在评估华法林对结肠直肠癌(CRC)患者生存率的影响与开始使用华法林的时机的关系:方法:研究人员从瑞典国家癌症登记处获得了瑞典Västra Götaland地区10051名年龄≥45岁、在2000年至2009年间确诊为CRC患者的数据。研究期间接受华法林治疗的患者(n= 1,216)为病例,未接受华法林治疗的患者(n= 8,873)为对照组。在进行统计分析时,将全国癌症登记数据与瑞典全国死因登记数据和地区华法林治疗登记数据合并:病例的 CRC 特异性死亡率危险率低于对照组。如果在任何时间因任何原因使用华法林,病例的 CRC 特异性死亡率明显低于女性对照组(危险比 [HR] 0.71;95 % 置信区间 [CI] 0.59-0.85;p= 0.0002)和男性对照组(HR 0.61;95 % 置信区间 [CI] 0.52-0.72;p < 0001)。在确诊 CRC 后接受华法林治疗可将 CRC 特异性死亡率降低 80%;但是,如果在确诊前或确诊后≥5 年接受华法林治疗,CRC 特异性死亡率并没有显著降低。避免1例死亡所需的治疗人数为4人:结论:CRC 患者在确诊后早期使用华法林可提高生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Warfarin intake in relation to diagnosis reduces mortality in patients with colorectal cancer – a register-based study

Background

Several studies have analyzed the effect of anticoagulants on cancer survival, with varying results. This study aimed to assess the effect of warfarin on survival in patients with colorectal cancer (CRC) in relation to timing of warfarin initiation.

Methods

Data on 10,051 individuals aged ≥45 years in the Västra Götaland Region of Sweden, and diagnosed with CRC between 2000 and 2009, were obtained from the Swedish National Cancer Register. Those who received warfarin treatment (n= 1,216) during the study period were labeled cases and those who did not (n= 8,873) were labeled controls. For statistical analysis, National Cancer Register data were merged with mortality data from the Swedish National Cause of Death register and data from the regional warfarin treatment register.

Results

Hazard rates for CRC-specific mortality were lower in cases than in controls. When warfarin was used for any reason at any time, cases had a significantly lower CRC-specific mortality than controls among both women (hazard ratio [HR] 0.71; 95 % confidence interval [CI] 0.59–0.85; p= 0.0002) and men (HR 0.61; 95 % CI 0.52–0.72; p < 0001). Warfarin treatment after CRC diagnosis reduced CRC-specific mortality by 80 %; however, when warfarin was given before or ≥5 years after diagnosis, CRC-specific mortality did not significantly decrease. The number needed to treat to avoid one death was four.

Conclusion

Use of warfarin early after diagnosis in patients with CRC was associated with improved survival.

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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
148
审稿时长
56 days
期刊介绍: Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.
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