Đánh giá kết quả điều trị ung thư đại trực tràng khởi phát sớm tại bệnh viện Ung bướu Nghệ An=Treatment outcomes of patients with early- onset colorectal cancer at Nghe An Oncology hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Thu Phương Mông, Thị Phương Nguyễn, Thị Thuỳ Linh Nguyễn, Thị Anh Thơ Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.177-185

Bộ sưu tập: Metadata

ID: 478137

Thêm vào giỏ

Đánh giá đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị của bệnh nhân ung thư đại trực tràng khởi phát sớm. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu có theo dõi dọc trên bệnh nhân trong độ tuổi dưới 50 được chẩn đoán ung thư đại trực tràng tại bệnh viện Ung Bướu Nghệ An từ 01/2017 đến 01/2023. Kết quả: 102 bệnh nhân được lựa chọn vào nghiên cứu. Tuổi phát hiện trung bình là 41,51 ± 12,66
trong đó độ tuổi hay gặp nhất là 40 – 49 (65 bệnh nhân, chiếm 63,73%). Tỉ lệ nam/nữ là 1,01/1. Tỉ lệ cấp cứu khi vào viện là 21/102 (20,59%) bệnh nhân . Dấu hiệu đau bụng phổ biến nhất gặp ở 81 (79,43%) bệnh nhân
phân có máu gặp ở 36 (35,29%) bệnh nhân. U đại tràng phải chiếm tỉ lệ cao nhất là 42 (41,18%) bệnh nhân, tổn thương dạng sùi gặp ở 54 (53,92%) bệnh nhân. Phân độ mô bệnh học biệt hóa vừa chiếm tỉ lệ cao nhất là 68 (66,67%) bệnh nhân. Bệnh nhân phát hiện bệnh ở giai đoạn IV là 43 (43,14%) bệnh nhân
giai đoạn II là 40 (39,22%) bệnh nhân và giai đoạn III là 18 (17,65%)
trong đó tỉ lệ di căn gan cao nhất găp ở 21 (20,59%) bệnh nhân. Có 81 (79,41%) bệnh nhân được phẫu thuật triệt căn. Bệnh nhân hóa chất bổ trợ là 55 (53,92%) bệnh nhân
hóa chất giảm nhẹ là 44 (43,14%) bệnh nhân, trong đó có phối hợp điều trị đích là 12 (11,16%) bệnh nhân. Có 11 bệnh nhân xạ trị, chiếm 10,78%. Trung vị sống thêm toàn bộ là 34 tháng, trung bình sống thêm toàn bộ là 34 ± 19 tháng. Có mối liên quan giữa nồng độ CEA, độ mô bệnh học và giai đoạn bệnh theo thời gian sống thêm toàn bộ, sự khác biệt có ý nghĩa thống kê (p <
0,05). Kết luận: Ung thư đại trực tràng khởi phát sớm có những đặc điểm lâm sàng, cận lâm sàng cũng như kết quả điều trị cho thấy bệnh được phát hiện ở giai đoạn muộn cùng nhiều yếu tố tiên lượng xấu. Những nghiên cứu sâu hơn về đặc điểm ung thư đại trực tràng ở người trẻ có thể sẽ mang đến cơ hội tối ưu hóa chiến lược sàng lọc và điều trị bệnh nhân trong quần thể đặc biệt này.To evaluate the clinical, paraclinical characteristics, and treatment outcomes of patients with early-onset colorectal cancer. Subjects and Methods: A retrospective descriptive study with longitudinal follow-up on patients under 50 years old diagnosed with colorectal cancer from January 2017 to January 2023 in Nghe An Oncology Hospital. Results: 102 patients were selected for the study. The average age at diagnosis was 41.51 ± 12.66
the most common age group was 40-49 (65 patients, 63.73%). The male/female ratio was 1.01/1. The rate of emergency hospitalization was 20.59% (21/102). Abdominal pain was the most common symptom, appearing in 81 patients (79.43%)
bloody stools were observed in 36 patients (35.29%). Right colon tumors accounted for the highest proportion 41.18% (42 patients), while papillomatous lesions were found in 54 patients (53.92%). Moderately differentiated histopathology had the highest rate with 66.67% (68 patients). 43 (43.14%) patients were diagnosed at stage IV
followed by stage II with 40 patients (39.22%), and stage III with 18 (17.65%). Liver metastasis had the highest rate, occurring in 21 patients (20.59%)
81 (79.41%) patients underwent radical surgery
55 (53.92%) patients received adjuvant chemotherapy
44 patients (43.14%) received palliative chemotherapy, of which 12 patients (11.16%) received combined targeted therapy
11 patients received radiotherapy, accounting for 10.78%. The median overall survival (OS) was 34 months, and the mean OS was 34 ± 19 months. There was a statistically significant correlation (p<
0.05) between CEA levels, histological grade, and disease stage with overall survival time. Conclusion: Early-onset colorectal cancer has clinical, paraclinical, and treatment characteristics that indicate late-stage disease with many poor prognostic factors. Further studies on colorectal cancer characteristics in young adults may provide opportunities to optimize screening and treatment strategies in this special population.

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