高危II期结肠癌复发危险因素的识别。
Identification of risk factors for recurrence in high-risk stage II colon cancer.
作者信息
Hatano Satoshi, Ishida Hideyuki, Ishibashi Keiichiro, Kumamoto Kensuke, Haga Norihiro, Miura Ichiro
机构信息
1 Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
出版信息
Int Surg. 2013 Apr-Jun;98(2):114-21. doi: 10.9738/CC131.
To identify risk factors for recurrence in patients with stage II colon cancer, Cox proportional hazards regression analysis was performed in 194 patients with stage II colon cancer who underwent curative surgery between April 1997 and December 2008. Thirteen clinical and pathologic factors, including use of fluoropyrimidine-based adjuvant chemotherapy in 113 of the patients (58.2%), were assessed. By multivariate analysis, only obstruction, perforation, and T4-level invasion were identified as independent risk factors affecting disease-free survival (DFS) (P < 0.01). The 5-year DFS rate was 70.6% in patients with one or more risk factors (n = 68) and 96.0% in patients with no risk factors (n = 126) (P < 0.01). These results suggest that obstruction, perforation, and T4-level invasion are suitable candidates for prediction of tumor recurrence in patients with stage II colon cancer. The oxaliplatin-based adjuvant chemotherapy, which has been reported to be effective in stage III colon cancer patients, may improve the prognosis in high-risk stage II colon cancer patients.
为了确定II期结肠癌患者复发的危险因素，对1997年4月至2008年12月期间接受根治性手术的194例II期结肠癌患者进行了Cox比例风险回归分析。评估了13项临床和病理因素，其中113例患者（58.2%）使用了氟嘧啶类辅助化疗。多因素分析显示，仅梗阻、穿孔和T4级浸润被确定为影响无病生存期（DFS）的独立危险因素（P<0.01）。有一个或多个危险因素的患者（n = 68）5年DFS率为70.6%，无危险因素的患者（n = 126）5年DFS率为96.0%（P<0.01）。这些结果表明，梗阻、穿孔和T4级浸润是预测II期结肠癌患者肿瘤复发的合适因素。据报道对III期结肠癌患者有效的奥沙利铂辅助化疗可能改善高危II期结肠癌患者的预后。
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