Hotta Tsukasa, Takifuji Katsunari, Arii Kazuo, Yokoyama Shozo, Matsuda Kenji, Higashiguchi Takashi, Tominaga Toshiji, Oku Yoshimasa, Yamaue Hiroki
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Anticancer Res. 2006 Mar-Apr;26(2B):1377-83.
The prognosis of patients with colorectal cancer is considered to be affected by several factors. Recently, chemotherapy for this disease has been demonstrated to be effective for long-term survival. In this study, the potential predictors, including chemotherapy regimens for survival after surgery, in patients with stage IV colorectal cancer are presented.
Univariate and multivariate analyses of potential predictors of survival after surgery were carried out for 56 patients with stage IV colorectal cancer who had undergone surgery, including 22 with rectal and 34 with colon cancer.
The survival in patients who had had a primary liver resection was longer than that in patients who had not (p=0.007). There was a significant difference among chemotherapy regimens (p=0.021). The survival in patients who were administered l-leucovorin/5-fluorouracil (l-LV/5FU) was longer than that in patients who received uracil-tegafur (UFT) and cisplatin (CDDP)/5FU (p=0.024, p=0.004, respectively). In multivariate analyses, there were 5 favorable factors that influenced overall survival after surgery: lymph node metastasis (p=0.029), no bone metastasis (p=0.012), no peritoneal invasion (p=0.018), no primary liver resection (p=0.004) and the chemotherapy regimen (p=0.008). Furthermore, the survival in patients with a continued l-LV/5FU plus modified IFL regimen (additional irinotecan) was longer than for those patients who received other regimens, in both univariate and multivariate analyses.
Five factors, namely lymph node metastasis, bone metastasis, peritoneal invasion, primary liver resection and chemotherapy, are potential predictors of survival after surgery for patients with stage IV colorectal cancer.
人们认为，多种因素会影响结直肠癌患者的预后。最近已证实，针对这种疾病的化疗对长期生存有效。在本研究中，我们呈现了IV期结直肠癌患者术后生存的潜在预测因素，包括化疗方案。
对56例接受手术的IV期结直肠癌患者进行了术后生存潜在预测因素的单因素和多因素分析，其中22例为直肠癌患者，34例为结肠癌患者。
接受原发性肝切除的患者生存期长于未接受肝切除的患者（p = 0.007）。化疗方案之间存在显著差异（p = 0.021）。接受亚叶酸钙/5-氟尿嘧啶（l-LV/5FU）治疗的患者生存期长于接受替加氟尿嘧啶（UFT）和顺铂（CDDP）/5FU治疗的患者（分别为p = 0.024和p = 0.004）。在多因素分析中，有5个有利因素影响术后总生存：淋巴结转移（p = 0.029）、无骨转移（p = 0.012）、无腹膜侵犯（p = 0.018）、未进行原发性肝切除（p = 0.004）以及化疗方案（p = 0.008）。此外，在单因素和多因素分析中，持续接受l-LV/5FU加改良IFL方案（加用伊立替康）治疗的患者生存期长于接受其他方案的患者。
淋巴结转移、骨转移、腹膜侵犯、原发性肝切除和化疗这5个因素是IV期结直肠癌患者术后生存的潜在预测因素。
