Surgical oncology · 2026
Endoscopic obstruction and site-specific metastatic patterns after curative resection of non-metastatic colorectal cancer: A two-center retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zeng Hao, Lan Kun, Wang Xiaojie, Zhu Baihan, Pan Hongfeng, Zhu Heyuan, Xu Dongbo, Lin Shuangming, Chi Pan, Huang Ying
Аннотация
PURPOSE: This study aimed to evaluate the association between preoperative endoscopic obstruction (eOB) and site-specific patterns of metastasis in patients with non-metastatic colorectal cancer (CRC) undergoing curative resection.
METHODS: This two-center retrospective cohort study included 2208 patients with non-metastatic colorectal cancer who underwent radical resection. eOB was present in 520 patients (23.6%). The primary endpoints were liver metastasis-free survival (LiMFS), lung metastasis-free survival (LuMFS), peritoneal metastasis-free survival (PMFS), and local recurrence-free survival (LRFS). Kaplan-Meier curves with log-rank tests were used to compare survival outcomes, with analyses stratified by primary tumor site. Multivariable Cox proportional hazards regression was employed to identify independent risk factors for organ-specific metastases.
RESULTS: Multivariable analysis identified endoscopic obstruction (eOB) as an independent risk factor for liver metastasis (HR = 3.00, 95% CI: 1.54-5.86, P = 0.001). Additionally, liver metastasis-free survival (LiMFS) was significantly reduced in patients with eOB, both in the overall cohort and in both the colon cancer and rectal cancer subgroups (all P < 0.001). In contrast, eOB showed no significant association with lung metastasis or local recurrence. Although eOB was associated with shorter peritoneal metastasis-free survival (PMFS) in patients with colorectal cancer (P < 0.05), it was not an independent risk factor after adjustment for T3-4 stage and pN2 stage. Furthermore, no association between eOB and PMFS was observed in rectal cancer.
CONCLUSIONS: Endoscopic obstruction is a promising clinical marker associated with advanced pathological features and appears to be an independent predictor of liver metastasis in this cohort. However, its incremental predictive value beyond standard pathologic factors and molecular features warrants further prospective validation.
METHODS: This two-center retrospective cohort study included 2208 patients with non-metastatic colorectal cancer who underwent radical resection. eOB was present in 520 patients (23.6%). The primary endpoints were liver metastasis-free survival (LiMFS), lung metastasis-free survival (LuMFS), peritoneal metastasis-free survival (PMFS), and local recurrence-free survival (LRFS). Kaplan-Meier curves with log-rank tests were used to compare survival outcomes, with analyses stratified by primary tumor site. Multivariable Cox proportional hazards regression was employed to identify independent risk factors for organ-specific metastases.
RESULTS: Multivariable analysis identified endoscopic obstruction (eOB) as an independent risk factor for liver metastasis (HR = 3.00, 95% CI: 1.54-5.86, P = 0.001). Additionally, liver metastasis-free survival (LiMFS) was significantly reduced in patients with eOB, both in the overall cohort and in both the colon cancer and rectal cancer subgroups (all P < 0.001). In contrast, eOB showed no significant association with lung metastasis or local recurrence. Although eOB was associated with shorter peritoneal metastasis-free survival (PMFS) in patients with colorectal cancer (P < 0.05), it was not an independent risk factor after adjustment for T3-4 stage and pN2 stage. Furthermore, no association between eOB and PMFS was observed in rectal cancer.
CONCLUSIONS: Endoscopic obstruction is a promising clinical marker associated with advanced pathological features and appears to be an independent predictor of liver metastasis in this cohort. However, its incremental predictive value beyond standard pathologic factors and molecular features warrants further prospective validation.