Esch Anouk, Coriat Romain, Perkins Géraldine, Brezault Catherine, Chaussade Stanislas
CHU Cochin-Port-Royal, service de gastroentérologie, 75014 Paris, France.
Presse Med. 2012 Jan;41(1):51-7. doi: 10.1016/j.lpm.2011.03.021. Epub 2011 Nov 23.
Being the second cancer for men and the third cancer for women in France, colorectal cancer represents a serious public health issue. Its incidence has increased these last years and despite new therapeutics being developed, it still has a bad prognostic. Thanks in part to Hemoccult national mass screening program, its diagnosis is made possible at an earlier stage, which makes a surgical curative resection and the carrying out of adjuvant chemotherapy possible. For stage III colic cancer that has been surgically removed, adjuvant chemotherapy by FOLFOX 4 has to be offered. Nevertheless, because of its toxicities, the patient's high age, important comorbidities or post-surgical complications, this chemotherapy occasionally cannot be done. What are the colorectal cancer prognostic factors which would guide the chemotherapy? TNM classification, number of examined lymph nodes, MSI status, and presence or not of a perforation or a perinervous, lymphatic or venous invasion is recognized prognostic factors. Also, what are the alternatives of FOLFOX 4 regimen as colorectal cancer adjuvant treatment?
在法国，结直肠癌是男性的第二大癌症和女性的第三大癌症，是一个严重的公共卫生问题。近年来其发病率有所上升，尽管有新的治疗方法正在研发，但预后仍然不佳。部分归功于国家潜血大规模筛查项目，结直肠癌得以在更早阶段被诊断出来，这使得手术根治性切除和辅助化疗成为可能。对于已手术切除的III期结肠癌患者，必须提供FOLFOX 4辅助化疗。然而，由于其毒性、患者年龄较大、合并症严重或术后并发症，这种化疗偶尔无法进行。哪些结直肠癌预后因素可指导化疗？TNM分类、检查的淋巴结数量、微卫星不稳定性（MSI）状态以及是否存在穿孔、神经周围、淋巴管或静脉侵犯是公认的预后因素。此外，作为结直肠癌辅助治疗，FOLFOX 4方案的替代方案有哪些？
