Background:Recently,studies have shown that plasma D-dimer and serum albumin are prognostic markers for esophageal cancer.The purpose of this study was to evaluate a novel prognostic scoring system—DA score(combinati...Background:Recently,studies have shown that plasma D-dimer and serum albumin are prognostic markers for esophageal cancer.The purpose of this study was to evaluate a novel prognostic scoring system—DA score(combination of preoperative plasma D-dimer and serum albumin levels)—and analyze the association between survival of patients with esophageal squamous cell carcinoma(ESCC) and their Glasgow prognostic score.Methods:In this retrospective study,preoperative biochemical markers and clinicopathologic factors in 260 ESCC patients treated with transthoracic esophagectomy were reviewed.According to receiver operating characteristic analysis,the cutoff values of D-dimer and albumin were defined as 0.5 μg/mL and 43.8 g/L,respectively.Patients with high D-dimer levels(>0.5 μg/mL) and low albumin levels(<43.8 g/L) were assigned a score of 2,those with only one of the two abnormalities were assigned a score of 1,and those with neither of the two abnormalities were assigned a score of 0.Results:ESCC patients with a DA score of 0,l,and 2 numbered 55,116,and 89,respectively.Survival analysis showed that patients with a DA score of 2 had lower overall survival(OS) rates than those with DA scores of 1 and 0(37.1%vs.52.6%and 76.4%,P < 0.001);similar findings were observed for disease-free survival(DFS) rates(32.6%vs.44.8%and67.3%,P < 0.001).In addition,the predictive value of the DA score was also significant in patients with stages l-IIA and stages IIB-IV ESCC.Multivariate Cox regression analyses indicated that hazard ratios(HRs) for predicting OS of patients with DA scores 1 and 2 were 2.25 {P — 0.010) and 3.14(P< 0.001),respectively,compared with those with a DA score of 0,and HRs for predicting DFS of patients with DA scores of 1 and 2 were 1.86(P = 0.023) and 2.68(P < 0.001),respectively,compared with those with a DA scores of 0.Conclusions:Our study suggests that preoperative DA scores are notably associated with postoperative survival of ESCC patients.展开更多
目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PS...目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PSM),最终将行达芬奇机器人辅助直肠癌根治术(达芬奇机器人组)、腹腔镜辅助直肠癌根治术(腹腔镜组)患者各51例纳入本研究。比较2组术中及术后情况,分析2组2年生存情况。结果达芬奇机器人组手术时间长于腹腔镜组,术中失血量、术后24 h C反应蛋白及疼痛数字评分法评分低于腹腔镜组,术后拔尿管时间短于腹腔镜组,差异均有统计学意义(P<0.05)。达芬奇机器人组术后并发症发生率为13.73%,腹腔镜组为15.69%,差异无统计学意义(P>0.05)。达芬奇机器人组、腹腔镜组中位生存时间分别为21.9、21.7个月,差异无统计学意义(χ^(2)=0.495,P=0.482)。达芬奇机器人组2年生存率为82.35%(42/51),腹腔镜组为76.47%(39/51),差异无统计学意义(χ^(2)=0.540,P=0.463)。结论达芬奇机器人辅助直肠癌根治术的根治效果、远期疗效与腹腔镜辅助直肠癌根治术相近,但前者更有利于降低术中失血量,缓解术后炎症及疼痛程度,并可促进患者泌尿功能的恢复。展开更多
基金supported by National Natural Science Funds for Distinguished Young Scholars(No.81325018)the National Key Scientific and Technological Project(Grant No.2011ZX09307-001-04)the National Basic Research Program of China(No.2011CB504303)
文摘Background:Recently,studies have shown that plasma D-dimer and serum albumin are prognostic markers for esophageal cancer.The purpose of this study was to evaluate a novel prognostic scoring system—DA score(combination of preoperative plasma D-dimer and serum albumin levels)—and analyze the association between survival of patients with esophageal squamous cell carcinoma(ESCC) and their Glasgow prognostic score.Methods:In this retrospective study,preoperative biochemical markers and clinicopathologic factors in 260 ESCC patients treated with transthoracic esophagectomy were reviewed.According to receiver operating characteristic analysis,the cutoff values of D-dimer and albumin were defined as 0.5 μg/mL and 43.8 g/L,respectively.Patients with high D-dimer levels(>0.5 μg/mL) and low albumin levels(<43.8 g/L) were assigned a score of 2,those with only one of the two abnormalities were assigned a score of 1,and those with neither of the two abnormalities were assigned a score of 0.Results:ESCC patients with a DA score of 0,l,and 2 numbered 55,116,and 89,respectively.Survival analysis showed that patients with a DA score of 2 had lower overall survival(OS) rates than those with DA scores of 1 and 0(37.1%vs.52.6%and 76.4%,P < 0.001);similar findings were observed for disease-free survival(DFS) rates(32.6%vs.44.8%and67.3%,P < 0.001).In addition,the predictive value of the DA score was also significant in patients with stages l-IIA and stages IIB-IV ESCC.Multivariate Cox regression analyses indicated that hazard ratios(HRs) for predicting OS of patients with DA scores 1 and 2 were 2.25 {P — 0.010) and 3.14(P< 0.001),respectively,compared with those with a DA score of 0,and HRs for predicting DFS of patients with DA scores of 1 and 2 were 1.86(P = 0.023) and 2.68(P < 0.001),respectively,compared with those with a DA scores of 0.Conclusions:Our study suggests that preoperative DA scores are notably associated with postoperative survival of ESCC patients.
文摘目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PSM),最终将行达芬奇机器人辅助直肠癌根治术(达芬奇机器人组)、腹腔镜辅助直肠癌根治术(腹腔镜组)患者各51例纳入本研究。比较2组术中及术后情况,分析2组2年生存情况。结果达芬奇机器人组手术时间长于腹腔镜组,术中失血量、术后24 h C反应蛋白及疼痛数字评分法评分低于腹腔镜组,术后拔尿管时间短于腹腔镜组,差异均有统计学意义(P<0.05)。达芬奇机器人组术后并发症发生率为13.73%,腹腔镜组为15.69%,差异无统计学意义(P>0.05)。达芬奇机器人组、腹腔镜组中位生存时间分别为21.9、21.7个月,差异无统计学意义(χ^(2)=0.495,P=0.482)。达芬奇机器人组2年生存率为82.35%(42/51),腹腔镜组为76.47%(39/51),差异无统计学意义(χ^(2)=0.540,P=0.463)。结论达芬奇机器人辅助直肠癌根治术的根治效果、远期疗效与腹腔镜辅助直肠癌根治术相近,但前者更有利于降低术中失血量,缓解术后炎症及疼痛程度,并可促进患者泌尿功能的恢复。
