Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Cancer Res Treat. 2007 Jun;39(2):61-4. doi: 10.4143/crt.2007.39.2.61. Epub 2007 Jun 30.
The purpose of this study is to determine whether the prognosis can be more precisely gauged by the revised 6th AJCC staging system and if this is suitable for Korean colorectal cancer patients, and especially for those patients in the Youngdong district.
Between September 1996 and December 2003, 365 patients with histologically confirmed colorectal cancer were analyzed. Kaplan-Meier analyses were used to compare the overall and stage-specific 5-year survival. All the statistical tests were two-sided.
The overall 5-year survival for the entire cohort was 62%. According to the stages defined by the AJCC fifth edition system, the 5-year stage-specific survival was 91% for stage I, 82% for stage II, 51% for stage III and 4% for stage IV. According to the stages defined by the AJCC sixth edition system, the 5-year stage-specific survival was 91% for stage I, 81% for stage IIa, 83% for stage IIb, 100% for stage IIIa, 64% for stage IIIb, 37% for stage IIIc and 4% for stage IV. The 5-year survival was significantly better for the patients with stage IIIb (64%) than those patients with stage IIIc (37%) (p<.001).
It is widely known that the AJCC sixth edition system for colorectal cancer stratifies survival more distinctly than does the fifth edition system by providing more substages. Our study showed that stage IIIb disease had better survival than stage IIIc disease, but we couldn't confirm that this new staging system is relevant in our Korean clinical practice due to the small study population. Therefore, further study is required in a larger population.
本研究旨在确定修订后的第 6 版 AJCC 分期系统是否能更准确地评估预后，以及其是否适用于韩国结直肠癌患者，尤其是勇洞区的患者。
1996 年 9 月至 2003 年 12 月，对 365 例经组织学证实的结直肠癌患者进行了分析。采用 Kaplan-Meier 分析比较总生存率和各分期的 5 年生存率。所有统计检验均为双侧检验。
全队列的总 5 年生存率为 62%。根据 AJCC 第 5 版系统定义的分期，各期 5 年生存率分别为：Ⅰ期 91%，Ⅱ期 82%，Ⅲ期 51%，Ⅳ期 4%。根据 AJCC 第 6 版系统定义的分期，各期 5 年生存率分别为：Ⅰ期 91%，Ⅱa 期 81%，Ⅱb 期 83%，Ⅲa 期 100%，Ⅲb 期 64%，Ⅲc 期 37%，Ⅳ期 4%。Ⅲb 期（64%）患者的 5 年生存率显著高于Ⅲc 期（37%）患者（p<.001）。
广泛认为，与第 5 版系统相比，第 6 版 AJCC 系统通过增加更多亚分期，更明确地分层了结直肠癌的生存情况。本研究表明，Ⅲb 期疾病的生存情况优于Ⅲc 期疾病，但由于研究人群较小，我们不能确定这一新的分期系统在韩国临床实践中的相关性。因此，需要在更大的人群中进行进一步的研究。
