在一项全国性队列研究中,原发性肿瘤切除或全身治疗作为孤立的同步结直肠癌腹膜转移患者的姑息性治疗。

IF 4.2 3区 医学 Q2 ONCOLOGY
Anouk Rijken, Vincent C J van de Vlasakker, Geert A Simkens, Koen P Rovers, Felice N van Erning, Miriam Koopman, Cornelis Verhoef, Johannes H W de Wilt, Ignace H J T de Hingh
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引用次数: 0

摘要

有限的数据可用于指导临床医生及其患者对孤立的同步性结直肠癌腹膜转移(CRC-PM)患者的姑息治疗选择的决策过程。因此,本研究的目的是分析不同姑息治疗对这些患者的疗效。2009年至2020年间(荷兰癌症登记处)诊断为孤立性同步CRC-PM并接受姑息治疗的所有患者均被纳入研究。接受紧急手术或治愈性治疗的患者被排除在外。患者被分为早期姑息性原发肿瘤切除术(有或没有额外的全身治疗)或仅姑息性全身治疗。比较两组总生存期(OS),并进行多变量cox回归分析。在1031例纳入的患者中,364例(35%)患者接受了原发肿瘤切除术,667例(65%)患者仅接受了全身治疗。原发肿瘤切除组60天死亡率为9%,全身治疗组为5% (P = 0.007)。原发肿瘤切除组OS为13.8个月,全身治疗组OS为10.3个月(P
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Primary tumor resection or systemic treatment as palliative treatment for patients with isolated synchronous colorectal cancer peritoneal metastases in a nationwide cohort study.

Primary tumor resection or systemic treatment as palliative treatment for patients with isolated synchronous colorectal cancer peritoneal metastases in a nationwide cohort study.

Limited data are available to guide the decision-making process for clinicians and their patients regarding palliative treatment options for patients with isolated synchronous colorectal cancer peritoneal metastases (CRC-PM). Therefore, the aim of this study is to analyze the outcome of the different palliative treatments for these patients. All patients diagnosed with isolated synchronous CRC-PM between 2009 and 2020 (Netherlands Cancer Registry) who underwent palliative treatment were included. Patients who underwent emergency surgery or curative intent treatment were excluded. Patients were categorized into upfront palliative primary tumor resection (with or without additional systemic treatment) or palliative systemic treatment only. Overall survival (OS) was compared between both groups and multivariable cox regression analysis was performed. Of 1031 included patients, 364 (35%) patients underwent primary tumor resection and 667 (65%) patients received systemic treatment only. Sixty-day mortality was 9% in the primary tumor resection group and 5% in the systemic treatment group (P = 0.007). OS was 13.8 months in the primary tumor resection group and 10.3 months in the systemic treatment group (P < 0.001). Multivariable analysis showed that primary tumor resection was associated with improved OS (HR 0.68; 95%CI 0.57-0.81; P < 0.001). Palliative primary tumor resection appeared to be associated with improved survival compared to palliative systemic treatment alone in patients with isolated synchronous CRC-PM despite a higher 60-day mortality. This finding must be interpreted with care as residual bias probably played a significant role. Nevertheless, this option may be considered in the decision-making process by clinicians and their patients.

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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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