在全国队列研究中，结肠癌切除术后的总生存率受到 TNM 分期、淋巴结比率、性别和年龄的不利影响。

Overall survival after resection for colon cancer in a national cohort study was adversely affected by TNM stage, lymph node ratio, gender, and old age.

机构信息

Department of Surgery, Haraldsplass Deaconal Hospital, University of Bergen, PO Box 6165, 5892, Bergen, Norway.

出版信息

Int J Colorectal Dis. 2011 Oct;26(10):1299-307. doi: 10.1007/s00384-011-1244-2. Epub 2011 May 12.

DOI:10.1007/s00384-011-1244-2

PMID:21562744

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3176397/

Abstract

BACKGROUND

A national surveillance program of colon cancer treatment was introduced in 2007. We examined prognostic factors for colon cancer operated in 2000 with an aim of improving survival in the new program and a special focus on the merit of lymph node yield.

METHODS

A cohort of 269 patients, 152 women (56.5%), with a mean age of 71 years, was operated for colon cancer in 2000 at three teaching hospitals and followed up for 7 years.

RESULTS

Overall 5-year survival was 58.0%, and overall hospital mortality was 5.2%, with 4.5% in elective cases and 12.5% after urgent surgery. In only 41.1% of the specimens were 12 or more lymph nodes retrieved, but this did not affect survival in the combined cohort, although one of the hospitals achieved a significantly better result with a harvest of 12 or more lymph nodes. In a multivariate analysis, old age, gender, a high lymph node ratio (LNR) at stage III, and tumor-node-metastasis stage were adverse factors for survival.

CONCLUSIONS

The operative mortality was high and should be reassessed. The lymph node count did not have a significant impact on outcome overall, whereas the LNR proved significant for stage III. A prospective protocol using overall lymph node yield as a surrogate measure for more radical surgery, nevertheless, seems warranted to improve the lymph node harvest according to international recommendations.

摘要

背景

2007 年引入了全国结肠癌治疗监测项目。我们研究了 2000 年接受结肠癌手术患者的预后因素，旨在提高新监测项目中的生存率，并特别关注淋巴结检出量的意义。

方法

选取了 2000 年在三所教学医院接受结肠癌手术的 269 例患者（女性 152 例，占 56.5%，平均年龄 71 岁）作为队列，并进行了 7 年的随访。

结果

总体 5 年生存率为 58.0%，总体院内死亡率为 5.2%，择期手术为 4.5%，紧急手术为 12.5%。只有 41.1%的标本检出 12 个或更多的淋巴结，但这并未影响整个队列的生存，尽管其中一家医院的淋巴结检出量达到 12 个或更多时，取得了明显更好的结果。多因素分析显示，年龄较大、女性、III 期淋巴结比例高（LNR）和肿瘤-淋巴结-转移分期是影响生存的不利因素。