2 型糖尿病对食管切除术患者短期及长期预后的不利影响
Type 2 diabetes mellitus confers unfavorable short- and long-term outcomes in patients undergoing esophagectomy.
作者
作者单位
- Department of Thoracic Surgery, Army Medical Center of PLA (Daping Hospital), Army Medical University, Changjiang Route #10, Daping, Chongqing, 400042, PR China.
- Department of Thoracic Surgery, Army Medical Center of PLA (Daping Hospital), Army Medical University, Changjiang Route #10, Daping, Chongqing, 400042, PR China. 164604535@qq.com.
- Department of Thoracic Surgery, Army Medical Center of PLA (Daping Hospital), Army Medical University, Changjiang Route #10, Daping, Chongqing, 400042, PR China. gyguowei@hotmail.com.
摘要
中文
2 型糖尿病（T2DM）是公认的各种慢性及急性疾病的风险因素。本研究主要旨在探讨 T2DM 对微创食管切除术（MIE）后医疗并发症及长期生存的影响。本回顾性研究共纳入 906 例接受 MIE 的食管鳞状细胞癌（ESCC）连续病例。根据术前是否合并 T2DM 将患者分为两组。采用倾向性评分匹配（PSM）平衡两组基线信息。PSM 后，无 T2DM 组（No-T2DM）最终纳入 324 例，合并 T2DM 组（Coe-T2DM）纳入 118 例。与 No-T2DM 组相比，Coe-T2DM 组总手术时间更长（225 vs 215；P = 0.039），术中出血量更多（100 vs 60；P = 0.001），术后并发症发生率更高（56.78% vs 39.20%，P < 0.001），严重并发症更多（29.66% vs 17.28%，P < 0.001）。此外，Coe-T2DM 组长期生存更差。Cox 多因素分析显示，T2DM 是影响 RRFS、DMFS、DFS 和 OS 的独立危险因素。T2DM 可能增加 MIE 治疗 ESCC 患者术后并发症的发生率和严重程度，并对长期生存产生不利影响。未接受二甲双胍治疗且血糖控制不佳的 T2DM 患者可能预示更差的预后。国家临床试验注册号：NCT06333665，注册日期 2024 年 3 月 21 日。
English
Type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for various chronic and acute conditions. The primary aim of this study was to investigate the influence of T2DM on medical complications and long-term survival following minimally invasive esophagectomy (MIE). A total of 906 consecutive patients with esophageal squamous cell carcinoma (ESCC) who underwent MIE were included in this retrospective study. Patients were categorized into two groups based on preoperative comorbidity with T2DM. Propensity score matching was utilized to align baseline information between the two groups. After PSM, 324 patients in the without-T2DM group (No-T2DM) and 118 patients in the Coexisting-T2DM group (Coe-T2DM) were ultimately included in the study. Compared with the No-T2DM group, the Coe-T2DM group exhibited longer total operative duration (225 vs 215; P = 0.039), more intraoperative blood loss (100 vs 60; P = 0.001), higher incidence of postoperative complications (56.78 vs 39.20%, P < .001), and more severe complication (29.66 vs 17.28%, P < .001). Furthermore, the Coe-T2DM group exhibited poorer long-term survival. The Cox multivariate analysis revealed that T2DM was an independent risk factor that influenced RRFS, DMFS, DFS, and OS. T2DM may increase the incidence and severity of postoperative complications and adversely affects the long-term survival after MIE for patients with ESCC. T2DM patients undergoing metformin-free therapy and exhibiting poor glycemic control may potentially indicate a worse prognosis. National clinical trials registry: NCT06333665, registered March 21, 2024.
分类与指标
- 研究类型
- 临床研究
- 病种
- 食管癌
- JCR 分区
- Q1
- 影响因子
- 11.8
- 新锐分区
- 1区