肾移植术后新发结直肠癌：一项系统综述和荟萃分析。

IF 6.4 1区医学 Q1 ONCOLOGY

British Journal of Cancer Pub Date : 2025-04-05 DOI:10.1038/s41416-025-02994-7

Bima J Hasjim, Arsha Ostowari, Monique Gandawidjaja, Mohsen D Mohammadi, Linda Suk-Ling Murphy, Matthew D Whealon, Valery Vilchez, Hirohito Ichii, Robert R Redfield, Oliver S Eng

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引用次数: 0

摘要

背景：与普通人群相比，肾移植（KT）患者发生新发结直肠癌（CRC）的风险更高。然而，由于大多数单中心或多中心的研究力度不足，缺乏普遍性，因此在其临床特征方面仍存在知识差距。方法：检索PubMed、Web of Science、Cochrane CENTRAL和Scopus数据库，检索截止到2024年7月22日发表的研究。研究报告了KT受体中新发CRC的临床病理特征和结果。结果：纳入49篇文献，涉及1855例发展为结直肠癌的KT患者。从移植到CRC诊断的平均时间为8.7年(95%CI为7.2,10.3年；i2 = 98·3%)。新生结直肠癌最常见于升结肠(43.6%；95%ci 29.5%, 58.9%；I2 = 55.3%)， 37.1%在诊断时为晚期CRC (95%CI 22.3%, 54.8%；i2 = 64·1%)。虽然68.8%的人接受了治愈性治疗(95%CI为45.4%,85.4%；I2 = 65.4%)，合并5年生存率为31.8% (95%CI 10.5%, 65.1%；i2 = 82.5%)。结论：在KT后不到10年的时间里，有近40%的患者在诊断时已经处于晚期。5年总生存率为31.8%。然而，研究之间存在广泛的异质性，需要进一步的研究。普洛斯彼罗注册号：CRD42023415767。

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De novo colorectal cancer after kidney transplantation: a systematic review and meta-analysis.

Background: Kidney transplant (KT) patients have higher risks of developing de novo colorectal cancer (CRC) compared to the general population. However, there is still a knowledge gap in their clinical characteristics, as most single- or multi-center efforts are underpowered and lack generalizability.

Methods: PubMed, Web of Science, Cochrane CENTRAL, and Scopus databases were queried for studies published until July 22^nd, 2024. Studies reporting the clinicopathologic characteristics and outcomes of de novo CRC among KT recipients were included.

Results: There were 49 articles included involving 1855 KT patients who developed CRC. The mean time from transplantation to CRC diagnosis was 8·7 years (95%CI 7·2, 10·3 years; I² = 98·3%). De novo CRC was most commonly located in the ascending colon (43·6%; 95%CI 29·5%, 58·9%; I² = 55·3%), and 37·1% had advanced CRC at diagnosis (95%CI 22·3%, 54·8%; I² = 64·1%). Although 68·8% underwent curative intent treatment (95%CI 45·4%, 85·4%; I² = 65·4%), pooled 5-year survival rate was 31·8% (95%CI 10·5%, 65·1%; I² = 82·5%).

Conclusions: De novo CRC was diagnosed in under 10 years after KT, and nearly 40% of patients already have advanced stage disease at diagnosis. The pooled rate of 5-year survival was 31.8%. However, there was wide heterogeneity between studies and further research is required. PROSPERO Registration: CRD42023415767.

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来源期刊

British Journal of Cancer 医学-肿瘤学

CiteScore

15.10

自引率

1.10%

发文量

383

审稿时长

6 months

期刊介绍： The British Journal of Cancer is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research.It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention,diagnosis and treatment.