Oncologic and surgical outcomes in colorectal cancer patients with liver cirrhosis: A propensity-matched studyReportar como inadecuado




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The management of colorectal cancer in patients with liver cirrhosis requires a thorough understanding of both diseases. This study evaluated the effect of liver cirrhosis on oncologic and surgical outcomes and prognostic factors in colorectal cancer patients. Fifty-five consecutive colorectal cancer patients with liver cirrhosis underwent colorectal resection LC group. Using a prospectively maintained database, these patients were matched 1:4 using propensity scoring with R programming language, package -MatchIt- and -optmatch- by sex, age, cancer location, and tumor stage with 220 patients without liver cirrhosis non-LC group, resulting in 275 patients. The 5-year overall survival OS was significantly worse in the LC group than in the non-LC group 46.7% vs. 76.2% respectively, P < 0.001; however, the 5-year proportion of recurrence free PRF rates were similar 73.1% vs. 84.5% respectively, P = 0.094. On multivariate analysis of the LC group, tumor-node-metastasis TNM stage ≥III disease, venous invasion, and a model for end-stage liver disease plus serum sodium MELD-Na score >10 were prognostic factors for OS. However, the OS was not different between the LC group with MELD-Na score ≤10 and the non-LC group 5-year OS rate, TNM stage ≤II, 85.7 vs 89.5%, p = 0.356; TNM stage ≥III, 41.1 vs 66.2%, p = 0.061. Colorectal cancer patients with liver cirrhosis have poorer OS compared to those without liver cirrhosis; however, the PRF rates are similar. It might be due to the mortality from the liver, and surgical treatment should be actively considered for patients with MELD-Na score <10.



Autor: Eon Chul Han, Seung-Bum Ryoo , Ji Won Park, Jin Wook Yi, Heung-Kwon Oh, Eun Kyung Choe, Heon-Kyun Ha, Byung Kwan Park, Sang Hui M

Fuente: http://plos.srce.hr/



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