[肿瘤大小对结肠癌患者预后的影响]

[Influence of tumor size on the prognosis in patients with colon cancer].

作者信息

Zhai Zhi-wei, Gu Jin

机构信息

Department of Colorectal Surgery, Peking University Cancer Hospital, Beijing, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 May;15(5):495-8.

PMID:22648846

Abstract

OBJECTIVE

To investigate the impact of tumor size on the prognosis of patients with colon cancer.

METHODS

The clinicopathologic factors of 345 cases who underwent curative surgery for colon cancer from January 2004 to June 2008 in the Peking University Cancer Hospital were analyzed retrospectively. The optimal cut-off value was determined by receiver-operator characteristic (ROC) analysis.

RESULTS

The overall 3-year survival rate was 85.1%. The optimal cut-off value was found to be 5.0 cm. The survival rate of patients with tumor size ≥5 cm and tumor size <5 cm was 79.5% and 90.5% respectively, and the difference was statistically significant(P=0.005). Multivariate analysis showed that preoperative CEA level (P=0.004), tumor size(P=0.020), regional lymph node metastasis(P=0.000), and lymphovascular invasion(P=0.002) were independent prognostic factors. Tumor size was significantly associated with overall survival in univariate and multivariate analyses in stage III( disease (P=0.011), but not in stage II( disease(P=0.827) using 5 cm as a cut-off.

CONCLUSIONS

Tumor size of 5 cm is an independent prognostic parameter for patients with stage III( colon cancer but not for stage II(. Determination of the association between tumor size and survival should be base on TNM staging.

摘要

目的

探讨肿瘤大小对结肠癌患者预后的影响。

方法

回顾性分析2004年1月至2008年6月在北京大学肿瘤医院接受结肠癌根治性手术的345例患者的临床病理因素。通过受试者工作特征（ROC）分析确定最佳截断值。

结果

总体3年生存率为85.1%。发现最佳截断值为5.0 cm。肿瘤大小≥5 cm和<5 cm患者的生存率分别为79.5%和90.5%，差异有统计学意义（P = 0.005）。多因素分析显示，术前癌胚抗原（CEA）水平（P = 0.004）、肿瘤大小（P = 0.020）、区域淋巴结转移（P = 0.000）和淋巴管侵犯（P = 0.002）是独立的预后因素。以5 cm为截断值，在Ⅲ期疾病的单因素和多因素分析中，肿瘤大小与总生存显著相关（P = 0.011），但在Ⅱ期疾病中无相关性（P = 0.827）。