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首页> 外文期刊>World Journal of Gastroenterology >Dose surgical sub-specialization influence survival in patients with colorectal cancer?
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Dose surgical sub-specialization influence survival in patients with colorectal cancer?

机译：手术亚专业化剂量是否影响大肠癌患者的生存？

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AIM: To perform a review of patients with colorectal cancer to a community hospital and to compare the risk-adjusted survival between patients managed in general surgical units versus a colorectal unit. METHODS: The study evaluated all patients with colorectal cancer referred to either general surgical units or a colorectal unit from 1/1996 to 6/2001. These results were compared to a historical control group treated within general surgical units at the same hospital from 1/1989 to 12/1994. A Kaplan-Meier survival analysis compared the overall survivals (all-cause mortality) between the groups. A Cox proportional hazards model was used to determine the influence of a number of independent variables on survival. These variables included age, ASA score, disease stage, emergency surgery, adjuvant chemotherapy and/or radiotherapy, disease location, and surgical unit. RESULTS: There were 974 patients involved in this study. There were no significant differences in the demographic details for the three groups. Patients in the colorectal group were more likely to have rectal cancer and Stage I cancers, and less likely to have Stage II cancers. Patients treated in the colorectal group had a significantly higher overall 5-year survival when compared with the general surgical group and the historical control group (56 % versus 45 % and 40 % respectively, P<0.01). Survival regression analysis identified age, ASA score, disease stage, adjuvant chemotherapy, and treatment in a colorectal unit (Hazards ratio: 0.67; 95 % CI: 0.53 to 0.84, P=0.0005), as significant independent predictors of survival. CONCLUSION: The results suggest that there may be a survival advantage for patients with colon and rectal cancers being treated within a specialist colorectal surgical unit.
机译：目的：对社区医院的结直肠癌患者进行回顾，并比较普通外科与结直肠癌患者经风险调整后的生存率。方法：本研究评估了从1/1996年至6/2001年间所有转诊为普通外科或结直肠癌的大肠癌患者。将这些结果与1/1989年至12/1994年在同一家医院的普通外科单元内治疗的历史对照组进行比较。 Kaplan-Meier生存分析比较了两组之间的总生存（全因死亡率）。使用Cox比例风险模型确定许多独立变量对生存的影响。这些变量包括年龄，ASA评分，疾病分期，急诊手术，辅助化疗和/或放疗，疾病位置和手术单位。结果：本研究涉及974例患者。三组的人口统计学细节无显着差异。大肠组的患者更可能患有直肠癌和I期癌症，而不太可能患有II期癌症。与普通外科手术组和历史对照组相比，在结肠直肠组接受治疗的患者的5年总生存期显着更高（分别为56％，45％和40％，P <0.01）。生存回归分析确定了年龄，ASA评分，疾病分期，辅助化疗和结直肠癌治疗（危险比：0.67； 95％CI：0.53至0.84，P = 0.0005），是生存的重要独立预测指标。结论：结果表明在结肠直肠癌专科手术室接受治疗的结肠癌和直肠癌患者可能具有生存优势。

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