RESUMO
Objective:To investigate the prognostic factors for long-term outcomes in elderly patients after colorectal cancer(CRC)resection.Methods:Patients(aged ≥60 years)undergone CRC resection in 2004 with more than 10-year survival records from the SEER database were retrospective analyzed.Potential prognostic risk factors for survival, such as age, sex, race, marital status, tumor site and size, clinical staging, TNM staging and lymph node clearance(lymph nodes dissection)were assessed by using the Cox proportional hazards model.Results:A total of 15 775 CRC patients were enrolled in this study, including 7 828(49.6%)males and 7 947(50.4%)females.The 10-year overall survival(OS)was shorter in patients aged over 80 years than in patients aged 60 years( P=0.000). Multivariate analysis showed that females had a better 10-year OS than males( P=0.000). Univariate analysis showed no difference in 10-year OS between females and males( P=0.837). Compared with married patients, single, unmarried or widowed patients displayed a poorer 10-year OS( P=0.000)and that patients with cecum and appendix cancer had the worst 10-year OS( P=0.000), but it did not find any difference between primary tumors in different sites.Patients with a tumor size over 5 cm or at advanced stage(T3-T4, N1-N2 and M1)had a low 10-year OS( P=0.000). Conclusions:Old age, black race, single, unmarried or widowed status, tumor size over 5 cm and advanced stage(T3-T4, N1-N2 and M1)are negative predictors for 10-year OS in CRC patients and these findings can be used for education and treatment improvement strategies for CRC in future.
RESUMO
Background: Colorectal cancer (CRC) is one of the most common malignancies in clinical practice. Its incidence and mortality rate are increasing in China in recent years. Aims: To analyze the results of CRC screening and the factors affecting the compliance of colonoscopy among community residents in Zhuanqiao Town, Minhang District, Shanghai. Methods: The community residents who were screened for CRC in Zhuanqiao Town from July 2020 to January 2021 were recruited. Both the risk assessment questionnaire and the fecal occult blood test (FOBT) were performed for the primary screening, and those who were positive for primary screening were recommended to undergo colonoscopy. High-risk individuals unwilling to undergo colonoscopy were surveyed for the reason of refusal. Results: During the study period, a total of 6 383 residents participated in the screening program, the positivity rates of risk assessment, FOBT and with either of them were 7.2% (459 cases), 10.5% (670 cases) and 17.2% (1 095 cases), respectively. Two hundred and ninety-seven residents who were positive for primary screening underwent a colonoscopy, with an overall colonoscopic compliance rate of 27.1%. The colonoscopic compliance rate in residents aged from 60-69 years was higher than that in other age groups (P<0.05). The detection rate of CRC was 2.0% (6/297). Insufficient knowledge of CRC and having no obvious physical discomfort were the main factors affecting colonoscopic compliance in high-risk population. Conclusions: Risk assessment combined with FOBT can identify high-risk population of CRC rapidly and efficiently. For the CRC screening program, education of the knowledge on CRC should be strengthened for improving the cognitive level of CRC in community residents. The screening program should be further optimized.
RESUMO
Background:Antibiotic resistance rate of Helicobacter pylori (Hp) has increased year by year,which leads to the lowering Hp eradication rate,therefore,it is emergent to find an effective Hp eradication regimen.Aims:To explore the effect of influencing factors on Hp eradication rate,and to investigate the clinical effect of Bifidobacterium on re-eradication of Hp.Methods:A total of 203 Hp-positive patients with gastric diseases diagnosed by gastroscopy and pathology were enrolled.All the patients were given standard triple regimen for 2 weeks,Hp infection was re-examined 4 weeks after treatment.Fifty patients with Hp eradication failure were divided into two groups,patients in experimental group were given Bifidobacterium followed by quadruple therapy,patients in control group were given quadruple therapy directly.Effects of gender,age,gastroscopic diagnosis,pathological diagnosis and different regimens on Hp eradication rate were analyzed,and effect of Bifidobacterium on re-eradication of Hp was evaluated.Results:No significant difference in Hp eradication rate was found between male and female patients (P =0.740).Hp eradication rate decreased with the increase of age,however,the difference was not statistically significant (P =0.872).No significant differences in Hp eradication rate were found between different eradication regimens,gastroscopic diagnosis,and pathological diagnosis (P ＞ 0.05).Reeradication rate of Hp in Bifidobacterium group was higher than that in control group,but the difference was not statistically significant (88.0％ vs.72.0％,P =0.289).Conclusions:The effects of gender,age,gastroscopic diagnosis and pathological diagnosis,different eradication regimens on Hp eradication rate are not statistically different.However,Hp eradication rate is decreased with the increase of age.Hp eradication rate is relatively high in patients with chronic atrophic gastritis.Bifidobacterium can not increase the re-eradication rate in patients with the failure of first time Hp eradication therapy.