Su Zhen, Guo Zhan-Wen, Mao Yan-Ping, Tang Jie, Lan Xiao-Wen, Xie Fang-Yun, Li Qun
Department of Radiation Oncology, Sun Yat-Sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Department of Radiation Oncology, The General Hospital of Shenyang Military Area Command, No.83, Wenhua Road, Shenhe District, Shenyang, Liaoning province, 110016, China.
J Cancer. 2017 Apr 9;8(6):1097-1102. doi: 10.7150/jca.17513. eCollection 2017.
Literature pertaining to prophylactic inguinal nodal treatment for anal adenocarcinoma in China is scarce.
In this retrospective study, we analyzed 126 patients from 1965 to 2015. Among these, 67 patients received surgery only, 18 patients received chemoradiotherapy only, 27 patients received a combination of both, and the remaining 14 patients received palliative treatment.
The median follow up period was 30 months. The 1-year, 3-year, and 5-year overall survival rates were 85.8%, 62.5%, and 43.4%, respectively. The 5-year overall survival was 46.9% for patients with negative inguinal lymph nodes and 19.1% for patients with positive inguinal lymph nodes (0.007). The overall 5-year inguinal node relapse-free survival was 83.0%. The 5-year inguinal node relapse-free survival was 87.5% for stage I, 86.9% for stage II, and 76.5% for stage III cancers. Among those with negative inguinal nodes, the 5-year inguinal node relapse-free survival was 85.7% for negative regional lymph nodes and 75.4% for positive regional lymph nodes (0.089).
Inguinal lymph node is a high-risk subclinical area. Prophylactic inguinal nodal treatment is necessary for patients with anal adenocarcinoma irrespective of positive or negative inguinal lymph nodes.
中国关于肛管腺癌预防性腹股沟淋巴结治疗的文献较少。
在这项回顾性研究中,我们分析了1965年至2015年期间的126例患者。其中,67例患者仅接受了手术,18例患者仅接受了放化疗,27例患者接受了两者的联合治疗,其余14例患者接受了姑息治疗。
中位随访期为30个月。1年、3年和5年总生存率分别为85.8%、62.5%和43.4%。腹股沟淋巴结阴性患者的5年总生存率为46.9%,腹股沟淋巴结阳性患者为19.1%(P = 0.007)。总体5年腹股沟淋巴结无复发生存率为83.0%。I期癌症的5年腹股沟淋巴结无复发生存率为87.5%,II期为86.9%,III期为76.5%。在腹股沟淋巴结阴性的患者中,区域淋巴结阴性者的5年腹股沟淋巴结无复发生存率为85.7%,区域淋巴结阳性者为75.4%(P = 0.089)。
腹股沟淋巴结是一个高危亚临床区域。肛管腺癌患者无论腹股沟淋巴结阳性或阴性,均需进行预防性腹股沟淋巴结治疗。