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Lancet:新辅助化疗后实现完全缓解的结肠癌患者可推迟手术

2018-06-23 zhangfan MedSci原创

研究发现,新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%,晚期病变罕见,但患者2年内局部复发风险较高,且复发位点均位于肠壁处,这表明延期手术患者接受规律的内镜监测是十分重要的

小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率。近日研究人员开展超过1000人的大规模研究,考察W&W策略的效果。

在新辅助治疗后未接受全直肠系膜切除术标准护理的直肠癌患参与研究,收集采取W&W策略CRC患者的临床资料,包括基线特征、新辅助治疗方案、影像资料,局部复发和远端转移率以及生存状况。研究的主要终点为局部复发及远端转移患者比例、5年总生存率和5年疾病特异性生存率。

1009名患者参与研究,其中880人实现无残留肿瘤迹象(cCR,87%)。平均随访3.3年。2年累积局部复发率为25.2%,88%的局部复发发生在诊断后前2年,97%的局部复发位于肠壁。71名患者出现(8%)远端转移。5年总生存率为85%,5年疾病特异性生存率为94%。

研究发现,新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%,晚期病变罕见,但患者2年内局部复发风险较高,且复发位点均位于肠壁处,这表明延期手术患者接受规律的内镜监测是十分重要的。

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    2018-08-28 howi
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1642457, encodeId=4bb7164245e20, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Nov 04 22:09:00 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829689, encodeId=d3d6182968918, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 28 03:09:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1678570, encodeId=f56916e857071, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Thu Oct 04 04:09:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326479, encodeId=e8cf3264e95a, content=研究发现.新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%.晚期病变罕见.但患者2年内局部复发风险较高.且复发位点均位于肠壁处.这表明延期手术患者接受规律的内镜监测是十分重要的., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:36 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326478, encodeId=242b3264e840, content=71名患者出现(8%)远端转移.5年总生存率为85%.5年疾病特异性生存率为94%., beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:18 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326477, encodeId=a1363264e73e, content=小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率., beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:17:57 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326321, encodeId=4d723263216a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 23 09:01:54 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326319, encodeId=48bf32631947, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Sat Jun 23 08:59:26 CST 2018, time=2018-06-23, status=1, ipAttribution=)]
    2018-06-24 随梦飞扬

    研究发现.新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%.晚期病变罕见.但患者2年内局部复发风险较高.且复发位点均位于肠壁处.这表明延期手术患者接受规律的内镜监测是十分重要的.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1642457, encodeId=4bb7164245e20, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Nov 04 22:09:00 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829689, encodeId=d3d6182968918, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 28 03:09:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1678570, encodeId=f56916e857071, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Thu Oct 04 04:09:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326479, encodeId=e8cf3264e95a, content=研究发现.新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%.晚期病变罕见.但患者2年内局部复发风险较高.且复发位点均位于肠壁处.这表明延期手术患者接受规律的内镜监测是十分重要的., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:36 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326478, encodeId=242b3264e840, content=71名患者出现(8%)远端转移.5年总生存率为85%.5年疾病特异性生存率为94%., beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:18 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326477, encodeId=a1363264e73e, content=小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率., beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:17:57 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326321, encodeId=4d723263216a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 23 09:01:54 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326319, encodeId=48bf32631947, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Sat Jun 23 08:59:26 CST 2018, time=2018-06-23, status=1, ipAttribution=)]
    2018-06-24 随梦飞扬

    71名患者出现(8%)远端转移.5年总生存率为85%.5年疾病特异性生存率为94%.

    0

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    2018-06-24 随梦飞扬

    小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率.

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1642457, encodeId=4bb7164245e20, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Nov 04 22:09:00 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829689, encodeId=d3d6182968918, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 28 03:09:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1678570, encodeId=f56916e857071, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Thu Oct 04 04:09:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326479, encodeId=e8cf3264e95a, content=研究发现.新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%.晚期病变罕见.但患者2年内局部复发风险较高.且复发位点均位于肠壁处.这表明延期手术患者接受规律的内镜监测是十分重要的., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:36 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326478, encodeId=242b3264e840, content=71名患者出现(8%)远端转移.5年总生存率为85%.5年疾病特异性生存率为94%., beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:18 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326477, encodeId=a1363264e73e, content=小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率., beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:17:57 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326321, encodeId=4d723263216a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 23 09:01:54 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326319, encodeId=48bf32631947, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Sat Jun 23 08:59:26 CST 2018, time=2018-06-23, status=1, ipAttribution=)]
    2018-06-23 龙胆草

    学习谢谢分享

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1642457, encodeId=4bb7164245e20, content=<a href='/topic/show?id=842f458e61f' target=_blank style='color:#2F92EE;'>#完全缓解#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45876, encryptionId=842f458e61f, topicName=完全缓解)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b5d22942638, createdName=小小小向日葵, createdTime=Sun Nov 04 22:09:00 CST 2018, time=2018-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829689, encodeId=d3d6182968918, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 28 03:09:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1678570, encodeId=f56916e857071, content=<a href='/topic/show?id=110c5869153' target=_blank style='color:#2F92EE;'>#新辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58691, encryptionId=110c5869153, topicName=新辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=941f27706894, createdName=charl1234576, createdTime=Thu Oct 04 04:09:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326479, encodeId=e8cf3264e95a, content=研究发现.新辅助化疗后实现完全缓解患者不接受手术治疗的5年生存率可达85%.晚期病变罕见.但患者2年内局部复发风险较高.且复发位点均位于肠壁处.这表明延期手术患者接受规律的内镜监测是十分重要的., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:36 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326478, encodeId=242b3264e840, content=71名患者出现(8%)远端转移.5年总生存率为85%.5年疾病特异性生存率为94%., beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:18:18 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326477, encodeId=a1363264e73e, content=小规模临床证实新辅助治疗后达到完全临床缓解的直肠癌患者可采取观望与等待策略(W&W)以降低患者手术率., beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Sun Jun 24 00:17:57 CST 2018, time=2018-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326321, encodeId=4d723263216a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 23 09:01:54 CST 2018, time=2018-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326319, encodeId=48bf32631947, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba101609906, createdName=happsf, createdTime=Sat Jun 23 08:59:26 CST 2018, time=2018-06-23, status=1, ipAttribution=)]
    2018-06-23 happsf

    学习

    0

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