Retrospective cohort study on prognosis impact of preoperative obstruction in colorectal cancer
10.3760/cma.j.issn115396-20211026-00417
- VernacularTitle:回顾性队列分析术前梗阻对结直肠癌生存预后的影响
- Author:
Jianning SONG
1
;
Zhigang BAI
;
Jun LI
;
Yun YANG
;
Guocong WU
;
Hongwei YAO
;
Jin WANG
;
Lan JIN
;
Dong WANG
;
Zhongtao ZHANG
;
Yingchi YANG
Author Information
1. 首都医科大学附属北京友谊医院普外科，国家消化系统疾病中心普外分中心，北京 100050
- Keywords:
Intestinal obstruction;
Colorectal neoplasms;
Prognosis;
Retrospective studies;
Cohort studies
- From:
International Journal of Surgery
2022;49(5):327-332,C2
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of obstruction on the prognosis and possible mechanisms in colorectal cancer patients.Methods:Among 1574 cases of colorectal cancer who were treated in Beijing Friendship Hospital, Capital Medical University from January 2003 to December. 2014, 194 cases had preoperative intestinal obstruction. Firstly, described the clinical characteristics of 194 patients with obstruction, then COX multivariate regression analysis was performed on the 1574 colorectal cancer cohort to confirm whether the preoperative obstruction was independent predictor for the overall survival. Finally, propensity score matching method was used to match obstruction and non-obstruction cases, then compared overall survival difference.Results:In 194 cases of obstructive colorectal cancer, 60.3% and 37.1% of the tumors were located in the left and right respectively. The 55.7% of the patients had tumors larger than 5 cm in diameter, the median survival time was 39.7 months (95% CI: 28.3-60.4). Multivariate COX analysis, after adjusted for related confounding factors, found that preoperative obstruction is still an independent risk factor for poor prognosis ( HR=1.41, 95% CI: 1.01-1.97). After propensity score matching, 140 and 560 patients were included in the obstructive group and the non-obstructive group. The two groups were more balanced in most baseline characteristics. The median survival time of the two groups was 42.4 and 116.3 months ( P<0.001), the overall survival of obstructive patients was significantly worse than that of non-obstructive patients. Conclusions:Preoperative obstruction is an independent risk factor for poor prognosis of colorectal cancer. This may be due to the difficulty of surgery and low radical cure rate for obstructive colorectal cancer.
