关于局部晚期直肠癌患者随访管理和支持策略的大型人群验证研究

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Yilin Yu, Haixia Wu, Liang Hong, Jianjian Qiu, Shiji Wu, Lingdong Shao, Cheng Lin, Zhiping Wang, Junxin Wu
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引用次数: 0

摘要

目标我们的目的是评估局部晚期直肠癌(RC)患者肝转移和肺转移的预测因素和转移时间。方法我们对RC患者肝转移和肺转移的风险因素和预后因素进行了变量和多变量分析。使用 Kaplan-Meier 模型计算生存概率,并使用对数秩检验进行组间比较。使用随机生存森林模型计算事件发生的时间概率。结果我们的研究结果表明,病理 T 分期和病理 N 分期是肝转移的独立预测因素。此外,CEA水平、病理T分期和肿瘤沉积物也是肺转移的独立预测因素。根据多变量 Cox 分析的结果,我们将肝转移和肺转移患者按评分分为三组。结果显示,得分越高的患者发生转移的概率越高。就肝转移而言,第 1、2 和 3 组在最初 24 个月内的发生率都较高。结论综上所述,我们建立了预测模型来确定 RC 患者发生肝转移和肺转移的可能性。对风险状况不佳的患者实施更密集的监测计划以促进转移的早期发现至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A large population-based and validated study on the follow-up management and supportive strategy of locally advanced rectal cancer patients

A large population-based and validated study on the follow-up management and supportive strategy of locally advanced rectal cancer patients

Objective

Our objective was to evaluate the predictive factors and metastatic time for liver and lung metastasis in locally advanced rectal cancer (RC) patients.

Methods

Univariate and multivariate analysis were performed to identify risk factors and prognostic factors for liver metastasis and lung metastasis in RC. Survival probabilities were calculated using the Kaplan–Meier model and compared using the log-rank test between groups. The probability of time-to-event occurrence was calculated using the random survival forest model. Finally, the SEER database was used to verify our findings.

Results

Our results indicated that pathological T stage and pathological N stage were independent predictive factors for liver metastasis. Furthermore, CEA level, pathological T stage, and tumor deposit were independent predictive factors for lung metastasis. Based on the results of a multivariate Cox analysis, we categorized patients with liver and lung metastasis into three groups based on their scores. The results revealed that patients with higher scores had a higher probability of experiencing metastasis. For liver metastasis, Groups 1, 2, and 3 all exhibited higher occurrence rates within the first 24 months. However, for lung metastasis, Group 4 showed the highest occurrence rate at the 12th month, while Groups 5 and 6 exhibited the highest occurrence rates at the 15th month.

Conclusions

In summary, we developed predictive models to determine the likelihood of liver and lung metastasis in RC patients. It is crucial to implement a more intensive surveillance program for patients with unfavorable risk profiles in order to facilitate early detection of metastasis.

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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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