原发灶切除与未切除对转移性结直肠癌疗效的荟萃分析

发布时间：2018-08-04 10:52

【摘要】：背景结直肠癌患者转移灶不可切除时,若原发灶引发穿孔、梗阻或出血等情况,一般情况下首先进行原发灶切除,然后全身化疗。但是对于初诊时原发灶无症状的患者,原发灶是否切除尚存在争议。故本研究就手术切除与非手术切除转移性结直肠癌患者的原发肿瘤疗效进行荟萃分析。患者与方法以MEDLINE数据库、PubMed数据库及EMBASE数据库为来源,文献均为公开发表,文献检索最后日期为2014年5月31日。比较转移性结直肠癌原发灶切除与否对患者生存的影响。评价指标为1、2、3年生存率和肿瘤相关并发症发生率(梗阻、穿孔、出血等)。计算手术切除和非手术切除组之间比值比(ORs)和95%可信区间(CI)。结果共有11篇文献纳入研究,包括2193名患者(手术切除组：1,111；非切除组,1,082人)。结果显示：手术切除组与非切除组相比,3年生存率(OR 2.22：95%CI 1.49-3.30),2年生存率(OR 2.37：95%CI1.77-3.18),1年生存率(OR 2.77：95%CI 2.19-3.50)。手术切除组与非切除组癌症相关并发症(梗阻、穿孔、出血等)相比(OR0.65：95%CI：0.53-0.80)。结论转移性结直肠癌原发灶切除可提高患者生存时间,同时可降低肿瘤相关并发症发生率。
[Abstract]:Background when the metastatic focus of colorectal cancer is unresectable, if the primary tumor causes perforation, obstruction or bleeding, the primary tumor is resected first and then chemotherapy is performed. However, for patients with asymptomatic primary lesions at the time of initial diagnosis, whether the primary focus is resected is still controversial. In this study, meta-analysis of primary tumor efficacy was carried out in patients with metastatic colorectal cancer after surgical and non-surgical resection. Methods the patients and methods were collected from MEDLINE database, pubMed database and EMBASE database. The literature was published publicly. The final date of literature retrieval was May 31, 2014. To compare the effect of primary resection of metastatic colorectal cancer on survival of patients. The 2-and 3-year survival rate and tumor-related complications (obstruction, perforation, hemorrhage, etc.) were evaluated. Calculate the ratio of (ORs) and 95% confidence interval (CI). Between surgical and nonoperative groups Results A total of 11 articles were included in the study, including 2193 patients (operative group: 1111; unresectable group: 1 082). The results showed that the 3-year survival rate (OR 2.22:95%CI 1.49-3.30), the 2-year survival rate (OR 2.37:95%CI1.77-3.18) and the 1-year survival rate (OR 2.77:95%CI 2.19-3.50) were higher in the surgical group than in the non-resection group. Cancer-related complications (obstruction, perforation, bleeding, etc.) in the surgical group compared with those in the non-resection group (OR0.65:95%CI:0.53-0.80). Conclusion resection of primary tumor of metastatic colorectal cancer can improve the survival time and decrease the incidence of tumor-related complications.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.34

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