坦桑尼亚一家三级医院早发与晚发结直肠癌的临床病理特征和短期手术效果:回顾性队列研究

George Kanani , Samwel Byabato , Jasmine Mrisho , Vihar Kotecha , Yasin Munis , Felician Kachinde , Ahmed Binde
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引用次数: 0

摘要

背景尽管据报道全球早发 CRC 发病率呈上升趋势,但坦桑尼亚和撒哈拉以南非洲地区的临床概况和初诊 CRC 手术结果却鲜为人知。本研究旨在分析接受初治手术的早发 CRC 患者的临床病理特征和短期手术效果。方法从前瞻性保存的医疗记录中识别并审查了接受初治 CRC 手术并经组织病理学确诊的患者。结果 本研究共纳入 225 例患者,其中晚发 CRC 组 137 例,早发组 88 例。按 1:1 比例进行 PSM 后,两组各有 86 名患者。早发 CRC 患者的总体比例为 39.1%。在性别、肿瘤分期、肿瘤位置和主要症状等基线特征方面,倾向得分匹配(PSM)分析前后,早发和晚发 CRC 患者组之间无明显差异(P > 0.05)。倾向得分匹配分析后,早发 CRC 患者的 Signet-ring 细胞组织学比例明显更高(p = 0.007),术后总并发症发生率也更高(p = 0.043)。多变量分析显示,早发 CRC 患者(p = 0.048,OR=2.14,95 % CI=1.01-4.53)和急诊手术(p = 0.011,OR=2.79,95 % CI=1.27-6.13)是术后总体并发症的重要预测因素。早期发病的 CRC 患者和急诊手术是术后短期并发症的重要预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinicopathological features and short-term surgical outcomes of early-onset versus late-onset colorectal cancer at a tertiary hospital in Tanzania: A retrospective-cohort study

Background

Despite the reported rising trend of early-onset CRC incidence globally, little is known about the clinical profile and primary CRC surgical outcome in Tanzania and sub-Saharan Africa. This study aimed to analyze the clinicopathological features and short-term surgical outcomes of early-onset CRC patients undergoing primary surgery.

Methodology

The patients who underwent primary CRC surgery and whose diagnosis was confirmed by histopathology were identified and reviewed from prospectively maintained medical records. Clinicopathological characteristics and short-term surgical outcomes were analyzed and compared between groups.

Results

A total of 225 patients were included in this study, there were 137 patients in the late-onset CRC group and 88 in the early-onset group. After a 1:1 ratio PSM, there were 86 patients in each group. The overall proportion of early-onset CRC patients was 39.1 %. With regards to baseline characteristics of gender, tumor stage, tumor location, and presenting symptoms, there was no significant difference between early-onset and late-onset CRC patient groups before and after propensity score Matching (PSM) analysis (p > 0.05). After PSM, Early-onset CRC patients had a significantly higher proportion of Signet-ring cell histology (p = 0.007) and a higher rate of overall postoperative complications, (p = 0.043). The multivariate analyses showed that early-onset CRC patients (p = 0.048, OR=2.14, 95 % CI=1.01–4.53) and emergency surgery (p = 0.011, OR=2.79, 95 % CI=1.27–6.13) were significant predictors of overall postoperative complications

Conclusion

Early-onset CRC patients showed a significantly higher proportion of Signet-ring cell histology (poorly differentiated) and overall short-term postoperative complications. The early-onset CRC patients and emergency surgery were significant predictors of overall short-term postoperative complications

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