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pT3亚组对R0切除的结直肠肿瘤预后的影响。

Influence of pT3 subgroups on outcome of R0-resected colorectal tumors.

作者信息

Mrak Karl, Jagoditsch Michael, Leibl Sebastian, Klingler Anton, Tschmelitsch Jörg

机构信息

Department of Surgery, Hospital of Barmherzige Brüder, St Veit/Glan, Graz, Austria.

出版信息

South Med J. 2011 Nov;104(11):722-30. doi: 10.1097/SMJ.0b013e3182321271.

Abstract

OBJECTIVE

Evaluate whether depth of infiltration within T3 colorectal tumors influences long-term oncologic outcome.

PATIENTS AND METHODS

Patients with stage pT3 colon and rectal tumors were divided into four subgroups according to the depth of infiltration. The influence on overall and disease-free survival was tested for each subgroup and compared in univariate and multivariate analyses.

RESULTS

A total of 368 patients were evaluated, with a median follow-up time of 92.5 months. In 181 patients with colon cancer 5- and 10-year overall survival rates were 82.7% and 65.0%, respectively, and 5- and 10-year disease-free survival rates were 80.9% and 64.4%, respectively. For 187 patients, rectal cancer 5- and 10-year overall survival rates were 69.0% and 50.5%, respectively, and disease-free survival rates were 61.3% and 47.5%, respectively. In either colon or rectal cancer, different pT3 categories showed neither a statistically significant influence on survival nor the occurrence of local or distant recurrence in univariate and multivariate analyses; however, higher pT3 subgroups had a significant influence on lymph node involvement and vessel invasion in patients with rectal cancer.

CONCLUSIONS

Subdivision of pT3 tumors in colon cancer based on depth of infiltration does not provide additional information about prognosis. In rectal cancer, T3 substages were associated with lymph node involvement; however, we could not demonstrate an impact on recurrence or survival.

摘要

目的

评估T3期结直肠癌的浸润深度是否会影响长期肿瘤学预后。

患者与方法

根据浸润深度,将pT3期结肠癌和直肠癌患者分为四个亚组。对每个亚组的总生存和无病生存影响进行检测,并在单因素和多因素分析中进行比较。

结果

共评估了368例患者,中位随访时间为92.5个月。181例结肠癌患者的5年和10年总生存率分别为82.7%和65.0%,5年和10年无病生存率分别为80.9%和64.4%。对于187例直肠癌患者,5年和10年总生存率分别为69.0%和50.5%,无病生存率分别为61.3%和47.5%。在结肠癌或直肠癌中,不同的pT3类别在单因素和多因素分析中对生存以及局部或远处复发的发生均无统计学显著影响;然而,较高的pT3亚组对直肠癌患者的淋巴结受累和血管侵犯有显著影响。

结论

基于浸润深度对结肠癌pT3肿瘤进行细分并不能提供关于预后的额外信息。在直肠癌中,T3亚分期与淋巴结受累相关;然而,我们未能证明其对复发或生存有影响。

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