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术前 CT 影像学分期评估对非转移性结肠癌患者的预后价值。

Prognostic value of preoperative radiological staging assessed by computed tomography in patients with nonmetastatic colon cancer.

机构信息

Departments of Surgery.

Diagnostic Radiology, Chonnam National University Hwasun Hospital and Medical School, Gwangju, Korea.

出版信息

Ann Oncol. 2012 May;23(5):1198-1206. doi: 10.1093/annonc/mdr404. Epub 2011 Sep 23.

Abstract

PURPOSE

This study evaluated the prognostic value of preoperative locoregional staging in patients with colon cancer and who underwent curative resection.

METHODS

A total of 536 consecutive patients who underwent curative resection for colon cancer from February 1999 to November 2007 were prospectively enrolled. The clinicopathological variables, including the radiological staging using computed tomography, were analyzed for the prognostic significance.

RESULTS

The 5-year overall survival rates of the patients with radiological T1, T2, T3, and T4 were 96%, 89%, 75%, and 79%, respectively (P = 0.028). The 5-year overall survival rates were 83%, 76%, and 54%, respectively, for patients with radiological N0, N1, and N2 disease (P < 0.001). The 5-year overall survival rates of the patients with radiological TNM (tumor-node-metastasis) stages I, II, and III were 90%, 81%, and 70%, respectively (P < 0.001) and the 5-year overall survival rates of the patients with pathological TNM stages I, II, and III were 93%, 80%, and 70%, respectively (P = 0.001). On multivariate analysis, the radiological T and N categories remained independent prognostic factors for both overall survival and disease-free survival.

CONCLUSION

Radiological staging is an independent predictor of long-term survival in the preoperative setting.

摘要

目的

本研究评估了接受根治性切除术的结肠癌患者术前局部区域分期的预后价值。

方法

前瞻性纳入 1999 年 2 月至 2007 年 11 月期间接受结肠癌根治性切除术的 536 例连续患者。分析了包括使用计算机断层扫描进行的影像学分期在内的临床病理变量,以评估其预后意义。

结果

影像学 T1、T2、T3 和 T4 分期的患者 5 年总生存率分别为 96%、89%、75%和 79%(P = 0.028)。影像学 N0、N1 和 N2 疾病患者的 5 年总生存率分别为 83%、76%和 54%(P < 0.001)。影像学 TNM(肿瘤-淋巴结-转移)分期 I、II 和 III 期的患者 5 年总生存率分别为 90%、81%和 70%(P < 0.001),而病理学 TNM 分期 I、II 和 III 期的患者 5 年总生存率分别为 93%、80%和 70%(P = 0.001)。多因素分析显示,影像学 T 和 N 分期仍然是总生存和无病生存的独立预后因素。

结论

影像学分期是术前预测长期生存的独立指标。

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