Service de Chirurgie Viscérale et Digestive CHU Angers, Angers Cedex 9, France.
Int J Colorectal Dis. 2010 Jul;25(7):829-34. doi: 10.1007/s00384-010-0934-5. Epub 2010 Apr 20.
There is a need to identify a subgroup of high-risk patients with node-negative colorectal cancer who have a poor long-term prognosis and may benefit from adjuvant therapies. The aim of this study was to evaluate the prognostic impact of clinical and pathological parameters in a retrospective study from a prospective, continuous database of homogenously treated patients.
This study included 362 patients operated in a single institution for Dukes A and B (node-negative) colorectal cancer. The median follow-up was 140 months. The prognostic value of 13 clinical and pathological parameters was investigated.
Multivariate analysis identified six independent prognostic factors: age at time of diagnosis (hazard ratio (HR) = 1.076), number of lymph nodes removed (HR = 0.948), perineural invasion (HR = 2.173), venous invasion (HR = 1.959), lymphatic vessel invasion (HR = 2.126), and T4 stage (HR = 5.876).
These parameters could be useful in identifying patients with high-risk node-negative colorectal cancer who should be presented to adjuvant therapy.
需要确定一组具有不良长期预后的低危结直肠癌患者，他们可能受益于辅助治疗。本研究旨在通过对一组连续前瞻性数据库中同质化治疗患者的回顾性研究，评估临床和病理参数的预后影响。
本研究纳入了在一家单机构接受 Dukes A 和 B（淋巴结阴性）结直肠癌手术的 362 名患者。中位随访时间为 140 个月。研究了 13 个临床和病理参数的预后价值。
多因素分析确定了六个独立的预后因素：诊断时的年龄（风险比（HR）=1.076）、切除的淋巴结数量（HR=0.948）、神经周围侵犯（HR=2.173）、静脉侵犯（HR=1.959）、淋巴管侵犯（HR=2.126）和 T4 期（HR=5.876）。
这些参数可用于识别具有高危淋巴结阴性结直肠癌的患者，这些患者应接受辅助治疗。
