New scoring system for the evaluation obstructive degrees based on computed tomography for obstructive colorectal cancer  

作　　者：Xin-Chang Shang-Guan Jun-Rong Zhang Chao-Nan Lin Shuai Chen Yong Wei Wen-Xuan Chen Lin Pan Li-Qin Huang Shao-Hua Zheng Xian-Qiang Chen 

机构地区：[1]Department of Emergency Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian Province,China [2]College of Physics and Information Engineering,Fuzhou University,Fuzhou 350001,Fujian Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2025年第3期122-132,共11页世界胃肠肿瘤学杂志(英文)

基　　金：the Youth Foundation of Fujian Provincial Health Commission,No.2021QNA014;the Construction Project of Fujian Province Minimally Invasive Medical Center,No.[2021]76.

摘　　要：BACKGROUND The degree of obstruction plays an important role in decision-making for obstructive colorectal cancer(OCRC).The existing assessment still relies on the colorectal obstruction scoring system(CROSS)which is based on a comprehensive analysis of patients’complaints and eating conditions.The data collection relies on subjective descriptions and lacks objective parameters.Therefore,a scoring system for the evaluation of computed tomography-based obstructive degree(CTOD)is urgently required for OCRC.AIM To explore the relationship between CTOD and CROSS and to determine whether CTOD could affect the short-term and long-term prognosis.METHODS Of 173 patients were enrolled.CTOD was obtained using k-means,the ratio of proximal to distal obstruction,and the proportion of nonparenchymal areas at the site of obstruction.CTOD was integrated with the CROSS to analyze the effect of emergency intervention on complications.Short-term and long-term outcomes were compared between the groups.RESULTS CTOD severe obstruction(CTOD grade 3)was an independent risk factor[odds ratio(OR)=3.390,95%confidence interval(CI):1.340-8.570,P=0.010]via multivariate analysis of short-term outcomes,while CROSS grade was not.In the CTOD-CROSS grade system,for the non-severe obstructive(CTOD 1-2 to CROSS 1-4)group,the complication rate of emergency interventions was significantly higher than that of non-emergency interventions(71.4%vs 41.8%,P=0.040).The postoperative pneumonia rate was higher in the emergency intervention group than in the non-severe obstructive group(35.7%vs 8.9%,P=0.020).However,CTOD grade was not an independent risk factor of overall survival and progression-free survival.CONCLUSION CTOD was useful in preoperative decision-making to avoid unnecessary emergency interventions and complications.

关 键 词：Obstructive colorectal cancer Scoring system Computed tomography-based obstructive degree Colorectal obstruction scoring system Emergency intervention 

分 类 号：R73[医药卫生—肿瘤]