Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, PR China.
Radiat Oncol. 2010 Dec 15;5:118. doi: 10.1186/1748-717X-5-118.
Adjuvant therapy for T3N0 rectal cancer was controversial with respect to both radiation and the use of a combined regimen of chemotherapy. We evaluated both clinical features and biomarkers and sought to determine risk factors for those patients retrospectively.
A total of 122 patients with T3N0 rectal cancer were analyzed in this study from January 2000 to December 2005. Clinicopathologic and biomarkers were used to predict local recurrence (LR), disease-free survival (DFS), and overall survival (OS).
The median follow-up interval was 45.4 months. Five-year LR, DFS, and OS rates were 10.4%, 68.3%, and 88.7%. Having a lower tumor location and showing low P21 and high CD44v6 expression were identified as risk factors for LR: patients with two or three of these risk factors had a higher 5-year LR rate (19.3%) than did patients with none or one of these risk factors (6.8%) (p = 0.05). A poorer DFS was related to low P21 nor high CD44v6 expression but not to tumor location: the 5-year DFS rates were 79.3% for those with neither, 65.9% for those with either one or the other, and 16.9% for those with both (p = 0.00).
The prognostic model including tumor location, P21 and CD44v6 expressions could help to distinguish these patients with high risk T3N0 patients and determine whether adjuvant therapy was beneficial.
对于 T3N0 直肠癌，辅助治疗在放疗和联合化疗方案的使用方面存在争议。我们评估了临床特征和生物标志物，并试图从回顾性角度确定这些患者的危险因素。
本研究共分析了 2000 年 1 月至 2005 年 12 月期间的 122 例 T3N0 直肠癌患者。临床病理和生物标志物用于预测局部复发（LR）、无病生存（DFS）和总生存（OS）。
中位随访时间为 45.4 个月。5 年 LR、DFS 和 OS 率分别为 10.4%、68.3%和 88.7%。肿瘤位置较低、P21 表达较低和 CD44v6 表达较高被确定为 LR 的危险因素：具有两个或三个这些危险因素的患者 5 年 LR 率（19.3%）高于没有或只有一个这些危险因素的患者（6.8%）（p=0.05）。DFS 较差与 P21 表达降低或 CD44v6 表达升高无关，但与肿瘤位置有关：无两者的 5 年 DFS 率为 79.3%，有一个或另一个的为 65.9%，两者均有的为 16.9%（p=0.00）。
包括肿瘤位置、P21 和 CD44v6 表达的预后模型可以帮助区分这些高危 T3N0 患者，并确定辅助治疗是否有益。
