Department of Medical Oncology, Institut Català d'Oncologia - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Colorectal Dis. 2013 Apr;15(4):414-22. doi: 10.1111/codi.12028.
Adjuvant 5-fluorouracil based chemotherapy has demonstrated benefit in Stage III colon cancer but still remains controversial in Stage II. The aim of this study was to analyse the prognostic impact of clinicopathological factors that may help guide treatment decisions in Stage II colon cancer.
Between 1996 and 2006 data from patients diagnosed with colorectal cancer at Hospital Universitari Bellvitge and its referral comprehensive cancer centre Institut Català d'Oncologia/L'Hospitalet were prospectively included in a database. We identified 432 patients with Stage II colon cancer operated on at Hospital Universitari Bellvitge. The 5-year relapse-free survival (RFS) and colon-cancer-specific survival (CCSS) were determined.
The 5-year RFS and CCSS were 83% and 88%, respectively. Lymphovascular or perineural invasion was associated with RFS [hazard ratio (HR) 1.84; 95% CI 1.01-3.35]. Gender (women, HR 0.48; 95% CI 0.23-1) and lymphovascular or perineural invasion (HR 3.51; 95% CI 1.86-6.64) together with pT4 (HR 2.79; 95% CI 1.44-5.41) influenced CCSS. In multivariate analysis pT4 and lymphovascular or perineural invasion remained significantly associated with CCSS. We performed a risk index with these factors with prognostic impact. Patients with pT4 tumours and lymphovascular or perineural invasion had a 5-year CCSS of 61%vs the 93% (HR 5.87; 95 CI 2.46-13.97) of those without any of these factors.
pT4 and lymphatic, venous or perineural invasion are confirmed as significant prognostic factors in Stage II colon cancer and should be taken into account in the clinical validation process of new molecular prognostic factors.
在 III 期结肠癌中，辅助 5-氟尿嘧啶化疗已显示出获益，但在 II 期结肠癌中仍存在争议。本研究旨在分析可能有助于指导 II 期结肠癌治疗决策的临床病理因素的预后影响。
1996 年至 2006 年期间，在 Hospital Universitari Bellvitge 和其转诊综合癌症中心 Institut Català d'Oncologia/L'Hospitalet 诊断为结直肠癌的患者数据被前瞻性地纳入数据库。我们确定了在 Hospital Universitari Bellvitge 接受手术治疗的 432 例 II 期结肠癌患者。确定了 5 年无复发生存率（RFS）和结肠癌特异性生存率（CCSS）。
5 年 RFS 和 CCSS 分别为 83%和 88%。淋巴管或神经周围侵犯与 RFS 相关[风险比（HR）1.84；95%置信区间（CI）1.01-3.35]。性别（女性，HR 0.48；95%CI 0.23-1）和淋巴管或神经周围侵犯（HR 3.51；95%CI 1.86-6.64）与 pT4（HR 2.79；95%CI 1.44-5.41）共同影响 CCSS。多变量分析中，pT4 和淋巴管或神经周围侵犯与 CCSS 显著相关。我们使用这些具有预后影响的因素进行了风险指数分析。具有 pT4 肿瘤和淋巴管或神经周围侵犯的患者 5 年 CCSS 为 61%，而无这些因素的患者为 93%（HR 5.87；95%CI 2.46-13.97）。
pT4 和淋巴管、静脉或神经周围侵犯被确认为 II 期结肠癌的显著预后因素，在新的分子预后因素的临床验证过程中应考虑这些因素。
