切除大肠癌患者使用抗生素与复发之间的关系:EVADER-1,一项全国范围的药物流行病学研究。

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Marc Hilmi, Ines Khati, Anthony Turpin, Antoine Andremont, Charles Burdet, Nathalie Grall, Joana Vidal, Philippe-Jean Bousquet, Benoît Rousseau, Christine Le Bihan-Benjamin
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引用次数: 0

摘要

背景:抗生素(ATB)对根治性切除术后结直肠癌(CRC)复发风险的影响仍然未知:方法:利用法国全国癌症患者数据库,纳入 2012 年 1 月至 2014 年 12 月期间切除的所有新诊断的非转移性结直肠癌患者。围手术期ATB摄入量(术前6个月至术后1年)根据类别、使用时间(切除术前或切除术后)、疾病分期(局部和局部晚期)和原发肿瘤位置(结肠和直肠/交界处)进行分类。主要终点是3年无病生存期(DFS)。采用时间依赖性多变量 Cox 模型评估了 ATB 的影响:共纳入 35,496 例 CRC 患者。79%的患者至少摄入过一次ATB。术后门诊ATB摄入量与不利的3年DFS相关。与3年DFS下降相关的ATB是头孢菌素类、链霉素类、喹诺酮类、青霉素A与β-内酰胺酶抑制剂以及抗真菌药物,根据原发肿瘤位置和疾病分期的不同,其影响也不同:这些研究结果表明,ATBs 可调节早期 CRC 切除术后的复发风险,根据疾病分期和肿瘤部位的不同,ATB 类药物的影响也不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between the antibiotics use and recurrence in patients with resected colorectal cancer: EVADER-1, a nation-wide pharmaco-epidemiologic study.

Background: The impact of antibiotics (ATBs) on the risk of colorectal cancer (CRC) recurrence after curative resection remains unknown.

Methods: Using the French nation-wide database of cancer patients, all newly diagnosed non-metastatic CRC patients resected between 01/2012 and 12/2014 were included. The perioperative ATB intake (from 6 months before surgery until 1 year after) was classified according to the class, the period of use (pre- vs post-resection), the disease stage (localized and locally advanced), and the primary tumor location (colon and rectum/junction). The primary endpoint was the 3-year disease-free survival (DFS). The impact of ATB was assessed using time-dependent multivariate Cox models.

Results: A total of 35,496 CRC patients were included. Seventy-nine percent of patients had at least one ATB intake. Outpatient ATB intake after surgery was associated with unfavorable 3-year DFS. The ATBs associated with decreased 3-year DFS were cephalosporins, streptogramins, quinolones, penicillin A with beta-lactamase inhibitors, and antifungals with differential effects according to the primary tumor location and disease stage.

Conclusion: These findings suggest that ATBs modulate the risk of recurrence after early CRC resection with a differential impact of the ATB classes depending on disease stage and tumor site.

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来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
期刊介绍: Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.
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