Cắt bỏ đồng thời hoặc theo giai đoạn đối với di căn gan đồng thời và ung thư trực tràng nguyên phát: phân tích so khớp điểm xu hướng

BMC Gastroenterology - Tập 22 - Trang 1-13 - 2022
Elias Karam1, Petru Bucur1, Camille Gil1, Remy Sindayigaya1, Nicolas Tabchouri1, Louise Barbier1, Urs Pabst-Giger2, Pascal Bourlier1, Thierry Lecomte3, Driffa Moussata3, Sophie Chapet4, Gilles Calais4, Mehdi Ouaissi1, Ephrem Salamé1
1Colorectal Surgery Unit, Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Chambray les Tours, France
2EA4245 Transplantation, Immunologie, Inflammation, Université de Tours, Tours, France
3Department of Hepatogastroenterology and Digestive Oncology, Trousseau Hospital, Chambray les Tours, France
4Department of Radiotherapy, Bretonneau Hospital, Tours, France

Tóm tắt

Ung thư đại trực tràng là loại ung thư phổ biến thứ ba ở Pháp và đến thời điểm chẩn đoán, 15–25% bệnh nhân sẽ bị di căn gan đồng thời. Phẫu thuật kết hợp với điều trị neoadjuvant có thể chữa khỏi cho những bệnh nhân này, nhưng ít nghiên cứu chỉ tập trung vào ung thư trực tràng. Nghiên cứu này nhằm so sánh kết quả của các bệnh nhân đã trải qua cắt bỏ đồng thời với những bệnh nhân đã trải qua cắt bỏ theo giai đoạn (trực tràng trước hoặc gan trước) tại Bệnh viện Đại học Tours, Pháp. Chúng tôi đã đánh giá hồi cứu một cơ sở dữ liệu duy trì theo hướng triển vọng về kết quả lâm sàng, bệnh lý và sống sót của những bệnh nhân đã trải qua cắt bỏ đồng thời hoặc cắt bỏ theo giai đoạn tại trung tâm của chúng tôi từ năm 2010 đến 2018. Phương pháp so khớp điểm xu hướng đã được sử dụng, xem xét các đặc điểm ban đầu của các nhóm của chúng tôi. Có 70 bệnh nhân (55/15 nam, nữ tương ứng) với độ tuổi trung bình 60 (54–68) năm. Sau khi so khớp, 48 (69%) trong số họ trải qua phương pháp theo giai đoạn và 22 (31%) phương pháp đồng thời đã được so sánh. Sau PSM, có 22 bệnh nhân trong mỗi nhóm. Không có sự khác biệt nào được tìm thấy về tỷ lệ bệnh tật (p = 0.210), khả năng sống sót tổng thể (p = 0.517) và khả năng sống sót không có bệnh (p = 0.691) sau 3 năm sau khi so khớp. Số lượng tái phát ở nhóm đồng thời ít hơn đáng kể (50% so với 81.8%, p = 0.026). Việc cắt bỏ đồng thời ung thư trực tràng nguyên phát và di căn gan đồng thời là an toàn và khả thi mà không có sự khác biệt về khả năng sống sót.

Từ khóa

#ung thư đại trực tràng #di căn gan #cắt bỏ đồng thời #cắt bỏ theo giai đoạn #tỷ lệ sống sót

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