细胞减少手术在转移性结直肠癌中越来越重要的作用——更有效的全身治疗时代的国家趋势。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-06-20 DOI:10.1002/jso.70012

Stephanie Young, Julia Greene, Daniel Milgrom, Jessica Weiss, Melanie Goldfarb, Anton Bilchik

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引用次数: 0

摘要

背景和目的：转移性结直肠癌（mCRC）的细胞减少手术（CRS）治疗指南仍然存在差异。本研究探讨了CRS治疗mCRC的生存结局和应用趋势。方法：来自美国国家癌症数据库的2004-2015年接受全身化疗的mCRC患者按结肠切除术、结肠切除术和转移切除术（CRS）和无手术（NS）进行分类。采用处理加权逆概率（IPTW）进行Kaplan-Meier分析。结果：88 593例患者中，39 028例患者行结肠切除术，21 462例CRS， 28 103例NS。CRS利用率从2004年的33.1%上升到2015年的38.3%。与NS相比，CRS （aHR = 0.36）和结肠切除术（aHR = 0.47）与OS显著改善相关。CRS与结肠切除术相比，IPTW患者的中位生存期更长（34.4个月vs. 26.7个月vs. 13.2个月）(p)。结论：全国CRS治疗mCRC的使用正在稳步增加，并与改善的生存期相关，支持在选定的患者中使用更积极的手术入路。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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An Increasing Role for Cytoreductive Surgery in Metastatic Colorectal Cancer-National Trends in the Era of More Effective Systemic Therapy.

Background and objectives: Treatment guidelines on cytoreductive surgery (CRS) for metastatic colorectal cancer (mCRC) continue to have variability. This study investigated survival outcomes and utilization trends of CRS on mCRC.

Methods: Patients from the National Cancer Database with mCRC who received systemic chemotherapy 2004-2015 were categorized by colectomy, colectomy and metastasectomy (CRS), and no surgery (NS). Kaplan-Meier analyses with inverse probability of treatment weighting (IPTW) were performed.

Results: Of 88 593 patients in the study cohort, 39 028 had a colectomy, 21 462 CRS, and 28 103 NS. CRS utilization increased from 33.1% (2004) to 38.3% (2015). CRS (aHR = 0.36) and colectomy (aHR = 0.47) were associated with significantly improved OS compared to NS. Median OS with IPTW remained longer in CRS versus colectomy versus NS (34.4 months vs. 26.7 vs. 13.2) (p < 0.001). Patients who received hyperthermic intraperitoneal chemotherapy (HIPEC) had improved OS compared to non-HIPEC patients (aHR = 0.55, p < 0.001).

Conclusions: National utilization of CRS for mCRC is steadily increasing and associated with improved OS, supporting the use of more aggressive surgical approaches in select patients.

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.