摘要
目的探讨电子衰弱指数(electronic frailty index,eFI)在预测中国结直肠癌患者术后长期预后中的潜在作用。方法选取2014年1月1日至2016年12月31日复旦大学附属肿瘤医院收治的接受手术治疗的4798例结直肠癌患者为研究对象。根据eFI将患者分为健康组(eFI=0)、轻度衰弱组(0<eFI<0.14)和衰弱组(eFI≥0.14)。比较3组患者术后5年总生存率(overall survival,OS)、5年无病生存率(disease-free survival,DFS)、住院花销、住院天数、ICU住院天数等。结果纳入3267名结直肠癌手术患者,男性占60.42%。健康组、轻度衰弱组和衰弱组分别为20.69%、74.90%和4.41%。衰弱组患者5年OS为60.8%,明显低于其他患者(健康组84.1%,轻度衰弱组79.9%,P<0.001)。衰弱组患者5年DFS为51.9%,明显低于其他患者(健康组76.5%,轻度衰弱组74.3%,P<0.001)。Cox回归分析显示,eFI评分、年龄(55~64岁/75岁+)、组织学类型(印戒细胞癌/腺癌)、分化程度(低分化/高分化)和TNM分期(Ⅱ/Ⅰ,Ⅲ/Ⅰ)均为5年OS及5年DFS的影响因素。结论eFI评分与中国结直肠癌手术患者长期预后显著相关。eFI评分越高,患者OS和DFS越低,预后越差。
Objective To investigate the potential role of electronic frailty index(eFI)in predicting long-term postoperative outcomes in Chinese patients with colorectal cancer.Methods A total of 4798 patients with colorectal cancer who received surgical treatment in Fudan University Shanghai Cancer Center from Jan 1,2014 to Dec 31,2016 were selected as the research subjects.According to eFI score,patients were categorized into fit group(eFI=0),mild fragile group(0<eFI<0.14)and fragile group(eFI≥0.14).The 5-year overall survival(OS),5-year disease-free survival(DFS),hospitalization costs,length of stay and length of ICU stay were compared among the three groups.Results A total of 3267 patients were enrolled,of which 60.42%were male.The fit group,mild fragile group and fragile group accounted for 20.69%,74.90%and 4.41%,respectively.The 5-year OS of the fragile group was 60.8%,significantly lower than that of the other patients(84.1%in the fit group and 79.9%in the mild fragile group,P<0.001).The 5-year DFS in the fragile group was 51.9%,significantly lower than that in the other patients(76.5%in the fit group and 74.3%in the mild fragile group,P<0.001).Cox regression analysis showed that eFI score,age(55-64 years/75 years+),histological type(sting ring cell/adenocarcinoma),differentiation(low/high)and TNM stageing(Ⅱ/Ⅰ,Ⅲ/Ⅰ)were influencing factors of 5-year OS and 5-year DFS.Conclusion eFI score was significantly associated with long-term prognosis in Chinese patients undergoing colorectal cancer surgery.The higher the eFI score,the lower the OS and DFS,and the worse the prognosis of patients.
作者
杨柳
周昌明
赵苇苇
许平波
YANG Liu;ZHOU Chang-ming;ZHAO Wei-wei;XU Ping-bo(Department of Anesthesiology,2Department of Cancer Prevention,3Department of Critical Care Medicine,Fudan University Shanghai Cancer Center/Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2023年第4期540-548,共9页
Fudan University Journal of Medical Sciences
