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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.99 No.2
- 발행연도
- 2020.8
- 수록면
- 82 - 89 (8page)
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초록· 키워드
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Purpose: The management of patients with colorectal cancer (CRC) who have liver cirrhosis (LC) requires a thorough understanding of both diseases; however, the prognoses and postoperative outcomes of such patients remain understudied. We investigated the effect of LC on surgical and oncologic outcomes in patients with CRC, and identified prognostic factors.
Methods: We analyzed 453 patients with CRC and LC (CRC-LC group), 906 with CRC only (CRC group), 906 with LC only (LC group), and 1,812 healthy subjects using health insurance claim data (2008–2013).
Results: The CRC-LC group had a higher frequency of intensive care unit admission than the CRC group; there were no differences between the 2 groups in terms of early and late postoperative small bowel obstruction and incisional hernia. However, the 30-day, 60-day, and 90-day mortality rates were all significantly higher in the CRC-LC group. The higher Charlson comorbidity index (hazard ratio [HR], 1.127) and the lower socioeconomic status (HR, 0.985) were significant worse predictors of 5-year survival. Patients with underlying LC had a significantly higher HR in both the advanced CRC (HR, 1.858) and nonadvanced CRC (HR, 1.799) subgroups. However, the nonadvanced CRC subgroup showed a lower HR than the LC group (HR, 0.730).
Conclusion: Patients with CRC who had underlying LC had a lower survival rate than did those without LC, although the incidence rates of postoperative complications were not significantly different. The presence of LC was associated with a significantly lower survival rate regardless of CRC presence.
Methods: We analyzed 453 patients with CRC and LC (CRC-LC group), 906 with CRC only (CRC group), 906 with LC only (LC group), and 1,812 healthy subjects using health insurance claim data (2008–2013).
Results: The CRC-LC group had a higher frequency of intensive care unit admission than the CRC group; there were no differences between the 2 groups in terms of early and late postoperative small bowel obstruction and incisional hernia. However, the 30-day, 60-day, and 90-day mortality rates were all significantly higher in the CRC-LC group. The higher Charlson comorbidity index (hazard ratio [HR], 1.127) and the lower socioeconomic status (HR, 0.985) were significant worse predictors of 5-year survival. Patients with underlying LC had a significantly higher HR in both the advanced CRC (HR, 1.858) and nonadvanced CRC (HR, 1.799) subgroups. However, the nonadvanced CRC subgroup showed a lower HR than the LC group (HR, 0.730).
Conclusion: Patients with CRC who had underlying LC had a lower survival rate than did those without LC, although the incidence rates of postoperative complications were not significantly different. The presence of LC was associated with a significantly lower survival rate regardless of CRC presence.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
Tsochatzis EA / 2014 / Liver cirrhosis / Lancet 383:1749~1761
Han EC / 2017 / Oncologic and surgical outcomes in colorectal cancer patients with liver cirrhosis : a propensity-matched study / PLoS One 12:e0178920
Friedman LS / 2010 / Surgery in the patient with liver disease / Trans Am Clin Climatol Assoc 121:192~204
Nguyen GC / 2009 / The impact of cirrhosis and portal hypertension on mortality following colorectal surgery : a nationwide, population-based study / Dis Colon Rectum 52:1367~1374
Lopez-Delgado JC / 2016 / Outcomes of abdominal surgery in patients with liver cirrhosis / World J Gastroenterol 22:2657~2667
Han EC / 2017 / Oncologic and surgical outcomes in colorectal cancer patients with liver cirrhosis : a propensity-matched study / PLoS One 12:e0178920
Friedman LS / 2010 / Surgery in the patient with liver disease / Trans Am Clin Climatol Assoc 121:192~204
Nguyen GC / 2009 / The impact of cirrhosis and portal hypertension on mortality following colorectal surgery : a nationwide, population-based study / Dis Colon Rectum 52:1367~1374
Lopez-Delgado JC / 2016 / Outcomes of abdominal surgery in patients with liver cirrhosis / World J Gastroenterol 22:2657~2667
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UCI(KEPA) : I410-ECN-0101-2020-514-001100182