筛查发现的结直肠腹膜转移瘤与临床发现的结直肠腹膜转移瘤在患者和肿瘤特征、治疗和存活率方面的差异

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-25 DOI:10.1016/j.ejso.2024.108789

L.J.K. Galanos , A. Rijken , M.A.G. Elferink , D. Boerma , A. Brandt-Kerkhof , P.R. de Reuver , J.B. Tuynman , N.F.M. Kok , P.H.J. Hemmer , W.M.U. van Grevenstein , C. Huysentruyt , F.N. van Erning , I.H.J.T. de Hingh

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引用次数: 0

摘要

导言：为提高癌症特异性生存率，已开始实施结直肠癌筛查。本研究旨在比较荷兰人群队列中筛查发现的和临床发现的同步结直肠腹膜转移（CPM）患者的患者和肿瘤特征、治疗和生存情况。在全国范围内进行筛查，每两年进行一次 FIT 检查，如果结果呈阳性，则随后进行结肠镜检查。2014年至2020年期间，筛查年龄（55-75岁）内且确诊为同步CPM的患者被纳入其中。国家癌症研究中心的数据与荷兰全国病理数据库（Palga）相连，以确定检测方式。使用χ2检验比较了筛查出的CPM患者和临床检测出的CPM患者的基线特征和治疗情况。结果在纳入的2773名同步CPM患者中，有197人（7%）是通过筛查发现的。在筛查发现组中，有56名（28%）患者接受了细胞切除手术和腹腔内热化疗（CRS-HIPEC），而在临床发现组中，有363名（14%）患者接受了细胞切除手术和腹腔内热化疗（P< 0.001）。筛查发现组的中位 OS 为 20.0 个月（IQR 9.7-51.7），而临床发现组为 10.8 个月（IQR 3.4-25.5）（p <0.001）。在多变量分析中，与临床检测出的 CPM 相比，通过筛查检测出的 CPM 与更佳的 OS 相关（调整后 HR 0.68，95%CI [0.57-0.81]）。

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Differences in patient- and tumor characteristics, treatment and survival between patients with screen-detected versus clinically detected colorectal peritoneal metastases

Introduction

Screening for colorectal cancer has been implemented to improve cancer-specific survival. This study aims to compare patient- and tumor characteristics, treatment, and survival between patients with screen-detected and clinically detected synchronous colorectal peritoneal metastases (CPM) in a Dutch population-based cohort.

Methods

Data from the Netherlands Cancer Registry (NCR) were used. Screening was performed nationwide with biennial FIT and subsequent colonoscopy if positive. Patients within the screening age (55–75 years) and diagnosed with synchronous CPM between 2014 and 2020 were included. Data from the NCR was linked to the Dutch Nationwide Pathology Databank (Palga) to identify mode of detection. Baseline characteristics and treatment were compared between screen-detected CPM patients and clinically detected CPM patients using χ₂-tests. Overall survival (OS) was compared between both groups with the log-rank test and a multivariable Cox regression analysis.

Results

Of 2,773 included patients with synchronous CPM, 197 (7 %) were detected by screening. In the screen-detected group, 56 (28 %) patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) versus 363 (14 %) in the clinically detected group (p < 0.001). Median OS was 20.0 months (IQR 9.7–51.7) in the screen-detected group versus 10.8 months (IQR 3.4–25.5) in the clinically detected group (p < 0.001). In the multivariable analysis, CPM detected through screening was associated with improved OS compared to clinically detected CPM (adjusted HR 0.68, 95%CI [0.57–0.81]).

Conclusions

Screen-detected patients with colorectal peritoneal metastases more often received treatment with curative intent and had better OS compared to clinically detected patients.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.