接受姑息治疗的结直肠癌患者延长生存期的相关因素:一项探索性研究

José António Ferraz-Gonçalves, Áurea Lima, Álvaro José Silva, Rita Calisto
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摘要

目的:最近发表的一项关于姑息治疗中与一年以上生存率相关的变量的研究包括几种类型的癌症。二级分析仅限于结直肠癌患者,以分析一组更均匀的患者。方法:2012年至2018年12月通过电子病历对患者进行鉴定。所有患者年龄均在18岁以上,均已死亡。病例定义为入住姑息治疗服务(PCS)后存活≥1年的患者,对照组定义为存活≤6个月的患者。结果:33例为病例,119例为对照组。男性82例(54%),中位年龄78.5岁(49 ~ 95岁)。在单变量分析中,与生存≥1年的低概率相关的变量是ECOG表现状态≥2、肝转移和疼痛。与生存期≥1年相关的变量为中性粒细胞计数≤5.66 × 109/L和中性粒细胞/淋巴细胞比值≤3.59。在多变量分析中,只有疼痛和肝转移与低概率相关,中性粒细胞/淋巴细胞比值≤3.59与高概率生存1年或1年以上相关。结论:本研究的数据表明,在入住PCS的结直肠癌患者中,疼痛、肝转移和高中性粒细胞/淋巴细胞比例的存在会对生存≥1年的概率产生负面影响。
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Factors Associated With Prolonged Survival in Colorectal Cancer Patients Admitted to Palliative Care: An Exploratory Study.

Objective: A recently published study concerning variables associated with survival longer than one year in palliative care included several types of cancer. A secondary analysis limited to patients with colorectal cancer was performed to analyze a more homogeneous group of patients.

Methods: Patients were identified through electronic records from 2012 to December 2018. All patients were over 18 years old and deceased. Cases were defined as patients who survived ≥1 year after being admitted to the palliative care service (PCS), while controls were those who had survived ≤6 months.

Results: The study includes 33 patients as cases and 119 as controls. 82 (54%) were male, and the median age was 78.5 years (49 to 95). In the univariable analysis, the variables associated with a low probability of living ≥1 year were an ECOG performance status ≥2, liver metastases, and pain. The variables associated with a survival ≥1 year were the neutrophil count ≤5.66 x 109/L and a neutrophil/lymphocyte ratio ≤3.59. In the multivariable analysis, only pain and liver metastases were associated with a low probability, and the neutrophil/lymphocyte ratio ≤3.59 with a high likelihood of living one year or more.

Conclusion: The data of this study suggests that in colorectal cancer patients admitted to a PCS, the presence of pain, liver metastases, and a high neutrophil/lymphocyte ratio negatively impact the probability of living ≥1 year.

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