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首页> 外文期刊>International journal of colorectal disease. >Laparoscopic and open resection of rectal canceris age an effect modifier for short- and long-term survival?
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Laparoscopic and open resection of rectal canceris age an effect modifier for short- and long-term survival?

机译：腹腔镜和开放切除直肠癌的年龄是短期和长期存活的作用改性剂吗？

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IntroductionRectal cancer is a frequently diagnosed tumor worldwide. Various studies have shown the noninferiority or even slight superiority of laparoscopic resection. However, there is no clear recommendation on whether age should influence the choice of surgical approach.Materials and methodsThis study compared outcomes of laparoscopic and open surgery in rectal cancer patients. Perioperative mortality and 5-year overall, relative, and recurrence-free survival rates were analyzed separately for three age groups. Data originate from 30 regional German cancer registries that cover approximately one quarter of the German population. All primary nonmetastatic rectal adenocarcinoma cases with surgery between 2005 and 2014 were eligible for inclusion. To compare survival rates, Kaplan-Meier analysis, a relative survival model, and multivariable Cox regression were used; a sensitivity analysis assessed bias by exclusion.ResultsTen thousand seven hundred fifty-four patients were included in the analysis. The mean laparoscopy rate was 23.0% and increased over time. Analysis of 30-day postoperative mortality rates revealed advantages for laparoscopically treated patients, although the significance level was not reached in any age group. Regarding 5-year overall survival, laparoscopy generally seems to be the superior approach, whereas for recurrence-free survival, an age-dependent gradient in effect size was observed: with a hazard ratio (HR) of 0.703 for laparoscopy, patients under 60years benefitted more from the minimally invasive approach than older patients (septuagenarians, HR 0.923).ConclusionLaparoscopy shows similar results to the open approach in terms of postoperative survival in all age groups. Concerning long-term outcomes, younger patients benefitted most from the minimally invasive approach.
机译：引导引导癌症是全球经常诊断的肿瘤。各种研究表明了腹腔镜切除术的不可损失甚至轻微优势。但是，无明确的建议是否应该影响手术方法的选择。在直肠癌患者中的腹腔镜和开放手术中的材料和方法研究。针对三个年龄组分别分别分析围手术期死亡率和5年的总体，相对和复发的存活率。数据来自30个地区德国癌症注册管理机构，涵盖了德国人口的大约四分之一。 2005年至2014年间手术中的所有初级非偶于直肠腺癌病例有资格包涵式。为了比较生存率，使用Kaplan-Meier分析，相对生存模型和多变量Cox回归;通过排除评估偏差的敏感性分析。分析中包括千七百五十四名患者。平均腹腔镜率为23.0％，随着时间的推移增加。 30天术后死亡率分析显示腹腔镜治疗患者的优势，尽管在任何年龄组中未达到意义程度。关于5年的总生存期，腹腔镜检查似乎似乎是优异的方法，而对于无复发存活，观察到效果大小的年龄依赖性梯度：腹腔镜检查的危险比（HR）为0.703，60岁以下的患者受益更多来自于比老年患者的微创方法（Septuagenanians，HR 0.923）。Conclusuallaparoscopy在所有年龄组术后生存方面显示出类似的结果。关于长期结果，年轻的患者受益于最微创的方法。

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