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J Gastroenterology: 大肠癌原发肿瘤位置对预后的影响

2020-10-03 MedSci原创 MedSci原创

在大肠癌中,原发性肿瘤的部位的预后价值已成为一个备受关注的话题。先前研究已经说明肿瘤位置对大肠癌预后的影响。

        在大肠癌中,原发性肿瘤的部位的预后价值已成为一个备受关注的话题。先前研究已经说明肿瘤位置对大肠癌预后的影响,但是仅按位置比较了两组,例如“右侧结肠与左侧结肠”,“结肠与直肠”和“右侧结肠与左侧结肠(左侧结肠和直肠)”的比较。本项多中心回顾性研究旨在通过将肿瘤分为三组:右侧结肠,左侧结肠和直肠,来明确肿瘤位置对III期大肠癌患者的预后影响。

       纳入的研究对象为1997年至2012年接受根治性手术的9194例III期大肠癌患者。研究人员检查了患者初次手术后的无复发生存期(RFS)和复发后的总生存期(OS),并进行了比较。

 

         结果显示:当校正了性别,年龄,组织学类型,CEA,辅助治疗,TNM分类后,与右侧结肠癌(n = 2362)(风险比(HR)0.65; 95%CI 0.59–0.72;p  <0.001)相比,直肠癌患者的无复发生存期更差。在复发患者中(n  = 2823),与右侧结肠癌相比,直肠癌的OS更好(HR 1.23; 95%CI 1.08-1.40;p  = 0.002),与左侧结肠癌相比,直肠癌的OS更差( HR 0.88; 95%CI 0.79-0.99;p = 0.029)。另外,右侧结肠癌复发中有20%表现为腹膜扩散,左侧结肠癌复发中42%是肝转移,而直肠癌复发中33%是局部复发。

 

        因此,我们发现右侧结肠,左侧结肠,直肠肿瘤对结肠癌患者行根治性切除术后的复发和整体死亡率具有不同的预后影响,表明肿瘤位置可作为III期结直肠癌的预后生物标志物。

 

原始出处:

Dai Shida. Et al. Prognostic impact of primary tumor location in Stage III colorectal cancer-right-sided colon versus left-sided colon versus rectum: a nationwide multicenter retrospective study. Journal of Gastroenterology.2020.

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    2020-12-05 许安
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    2020-12-18 148bfd96m52暂无昵称

    学习了

    0

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