结直肠癌切除术后开始辅助化疗延迟的独立影响因素分析  

Identification of independent factors associated with delay of commencement of adjuvant chemotherapy following colorectal resection

作　　者：董帅军[1] 韩保卫[1] 王战会[1] 李朝辉[1] 韩鸿彬[1] 许震[1] 刘帅峰[1] 

机构地区：[1]郑州大学附属洛阳中心医院胃肠胰腺外科,洛阳471009

出　　处：《中华实验外科杂志》2015年第6期1421-1423,共3页Chinese Journal of Experimental Surgery

基　　金：洛阳市科技发展基金资助项目（1301069A-3）

摘　　要：目的 探讨结直肠癌患者术后辅助化疗开始时间的独立影响因素.方法 收集本科2008年至2013年结直肠癌患者资料,所有Ⅱ～Ⅲ期结直肠癌术后接受辅助化疗的患者纳入本研究.主要通过COX比例风险回归模型分析影响术后开始辅助化疗时间的独立因素.结果 187例行结直肠癌根治术并接受术后辅助化疗的患者纳入本研究.患者术后住院时间中位数为6（4,8）d,手术至化疗时间间隔中位数为56（44,68）d,术后住院时间与手术至化疗时间间隔之间存在正相关（r =0.328,P＜0.05）.COX回归分析显示腹腔镜手术、造口术、淋巴转移度、吻合口漏和术前血清白蛋白水平（P＜0.05）是手术至化疗时间间隔的独立影响因素,同时也独立的影响患者术后住院时间.腹腔镜手术患者术后住院时间短,开始辅助化疗时间早.结论 本研究鉴定出腹腔镜手术、造口术、淋巴转移度、吻合口漏和术前血清白蛋白水平是影响结直肠癌患者术后开始辅助化疗时间的独立因素.Objective Timely commencement of adjuvant chemotherapy following colorectal resection benefits clinical outcome.The aim of present study is to identify clinical factors independently influencing time to commencement of adjuvant chemotherapy following colorectal resection.Methods Data of colorectal cancer patients,hospitalized between 2009 and 2013 in our department,were collected.All the patients with stages Ⅱ-Ⅲ colorectal cancer who received adjuvant chemotherapy following surgical resection were included in this study.COX proportional hazards regression model was employed to analyze the patients data to identify the clinical factors independently associated with delay of commencement of adjuvant chemotherapy following surgical resection.Results 187 patients who were treated with adjuvant chemotherapy following colorectal resection were enrolled in this study.The median postoperative inpatient time were 6 （4,8） days;and the median time interval from operation to adjuvant chemotherapy were 56 （44,68） days.The postoperative inpatient time correlated positively with the time interval form operation to chemotherapy （r =0.328,P ＜ 0.05）.COX regression analysis indicated that laparoscopic surgery,stoma,lymph node ratio,anastomotic leak and preoperative serum albumin were independent factors associated with time interval from operation to chemotherapy and postoperative hospital stay.Particularly worth mentioning is that the use of laparoscopic surgery was associated with shorter postoperative hospital stay and shorter time interval from operation to chemotherapy.Conclusion In present study our data showed that laparoscopic surgery,stoma,lymph node ratio,anastomotic leak and preoperative serum albumin were independent factors associated with the time interval from operation to adjuvant chemotherapy.

关 键 词：结直肠癌 结直肠癌根治术 辅助化疗 淋巴转移度 

分 类 号：R735.34[医药卫生—肿瘤]