Ishizuka M, Nagata H, Takagi K, Kubota K
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. mm-ishizuka @ umin.ac.jp
Eur Surg Res. 2011;46(2):57-64. doi: 10.1159/000321318. Epub 2010 Dec 7.
Surgical resection is the most effective treatment for patients with stage II colorectal cancer (CRC). However, a few patients with early-phase CRC suffer postoperative cancer death.
To investigate the risk factors for postoperative cancer death in patients who undergo surgery for stage II CRC.
Prognostic significance was analyzed by χ(2) test, univariate analyses, Kaplan-Meier analysis and log-rank test using clinicopathological factors from the database.
A total of 205 patients with stage II CRC were evaluated. Age (≤ 65/>65 years), venous invasion (negative/positive), number of dissected lymph nodes (≤ 9/≥ 10), grade of lymph node dissection (sufficient/insufficient) and albumin level (< 3.5/≥ 3.5 g/dl) were associated with shorter overall survival. Univariate analysis of the clinicopathological factors revealed that only the grade of lymph node dissection (sufficient/insufficient) was associated with postoperative cancer death (odds ratio 2.993, 95% confidence interval 1.216-7.368, p = 0.017).Kaplan-Meier analysis and log-rank test revealed that the group with insufficient lymph node dissection had a higher incidence of postoperative cancer death than the group with sufficient dissection (p < 0.001).
Insufficient lymph node dissection is an independent risk factor for postoperative cancer death in patients who undergo surgery for stage II CRC.
手术切除是II期结直肠癌(CRC)患者最有效的治疗方法。然而,少数早期CRC患者术后会出现癌症死亡。
探讨II期CRC手术患者术后癌症死亡的危险因素。
使用数据库中的临床病理因素,通过χ(2)检验、单因素分析、Kaplan-Meier分析和对数秩检验分析预后意义。
共评估了205例II期CRC患者。年龄(≤65/>65岁)、静脉侵犯(阴性/阳性)、清扫淋巴结数量(≤9/≥10)、淋巴结清扫分级(充分/不充分)和白蛋白水平(<3.5/≥3.5g/dl)与总生存期缩短相关。对临床病理因素的单因素分析显示,只有淋巴结清扫分级(充分/不充分)与术后癌症死亡相关(比值比2.993,95%置信区间1.216-7.368,p=0.017)。Kaplan-Meier分析和对数秩检验显示,淋巴结清扫不充分组的术后癌症死亡发生率高于清扫充分组(p<0.001)。
淋巴结清扫不充分是II期CRC手术患者术后癌症死亡的独立危险因素。