Long-term survival outcomes of laparoscopic surgery in patients with colorectal cancer:A propensity score matching retrospective cohort study  

作　　者：Ruoxi Tian Jiyun Li Fei Huang Pu Cheng Mandoula Bao Liming Zhao Zhaoxu Zheng 

机构地区：[1]Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China

出　　处：《Chinese Journal of Cancer Research》2024年第6期768-780,共13页中国癌症研究(英文版)

基　　金：supported by the Beijing Medical Award Foundation(No.YXJL-2023-0670-0150)。

摘　　要：Objective:Colorectal cancer(CRC)surgeries can be performed using either laparoscopic or open laparotomy approaches.However,the long-term outcomes based on tumor location and age remain unclear.This study compared the long-term outcomes of laparoscopic and laparotomy surgeries in patients with CRC,focusing on tumor location and age to identify suitable subgroups and determine an optimal cut-off age.Methods:This retrospective study analyzed 2,014 patients with CRC who underwent radical surgery.Patients were categorized into laparoscopy and laparotomy groups,and propensity score matching(PSM)was performed.Kaplan-Meier analysis,log-rank tests,and Cox regression models were used to identify the independent factors affecting overall survival(OS).Results:Analysis results before PSM indicated higher OS in the laparoscopy group(P=0.035);however,it was no significant difference in mean OS between the two groups after PSM analysis.Cox regression analysis identified several factors influencing the OS of patients with CRC,with age,T stage,nodal involvement,poorly differentiated adenocarcinoma,ascites,preoperative intestinal obstruction,and local tumor spread as independent risk factors.Family history was a protective factor[hazard ratio(HR)=0.33;95%CI,0.16-0.68;P=0.002],and the surgical modality did not independently affect OS.The subgroup analysis highlighted the advantages of laparoscopic surgery in specific subgroups.Conclusions:Overall,laparoscopic and laparotomy surgeries resulted in similar mid-and long-term prognoses for patients with CRC.Laparoscopic surgery showed better outcomes in specific subgroups,particularly in patients aged>60 years and in those with right-sided colon carcinoma.This study suggests that age>64 years might be the optimal cut-off age for laparoscopic surgery.

关 键 词：Colorectal cancer laparoscopic surgery LAPAROTOMY overall survival subgroup analysis right-sided colon carcinoma 

分 类 号：R73[医药卫生—肿瘤]