Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Korea.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.
Ann Surg Oncol. 2019 Apr;26(4):1118-1126. doi: 10.1245/s10434-019-07179-0. Epub 2019 Jan 25.
A family history (FH) of colorectal cancer (CRC) increases the risk for development of CRC, but the impact of FH of CRC on survival from sporadic CRC is unclear. This study investigated the prognostic impact of FH of CRC on the recurrence and survival of patients with sporadic CRC.
We reviewed the records of patients with sporadic CRC from two tertiary referral hospitals in Korea who underwent surgical resection between May 2007 and September 2013. The clinicopathologic features and oncologic outcomes of those with and without FHs of CRC were compared.
We examined the records of 2960 eligible patients, 163 (5.5%) of whom had first-degree relatives with CRC. Patients with and without FHs of CRC had similar baseline characteristics. Multivariable analysis indicated that a FH of CRC was not significantly associated with disease-free survival but was significantly associated with better overall survival (OS) [adjusted hazard ratio = 0.539, 95% confidence interval (CI) 0.330-0.881, P = 0.014]. Subgroup analysis indicated that females and rectal cancer patients with FHs of CRC had significantly better prognoses. Microsatellite status did not affect the improved survival rate associated with FH.
This study of patients with sporadic CRC indicated that those who had FHs of CRC had better OS but similar cancer recurrence as those who had no FH of CRC. The effect of FH of CRC on OS was independent of microsatellite status. Further studies are needed to identify underlying mechanisms and determine the optimal clinical management of CRC according to FH.
结直肠癌（CRC）家族史（FH）会增加 CRC 的发病风险，但 FH 对散发性 CRC 生存的影响尚不清楚。本研究旨在调查 FH 对散发性 CRC 患者复发和生存的预后影响。
我们回顾了 2007 年 5 月至 2013 年 9 月期间在韩国两家三级转诊医院接受手术切除的散发性 CRC 患者的病历。比较了有 FH 和无 FH 的 CRC 患者的临床病理特征和肿瘤学结局。
我们共纳入了 2960 例符合条件的患者，其中 163 例（5.5%）的一级亲属患有 CRC。有 FH 和无 FH 的 CRC 患者的基线特征相似。多变量分析表明，FH 与无病生存率无关，但与总生存率（OS）显著相关[调整后的危险比=0.539，95%置信区间（CI）0.330-0.881，P=0.014]。亚组分析表明，女性和有 FH 的直肠 CRC 患者的预后明显更好。微卫星状态不影响 FH 与生存率提高相关。
本研究对散发性 CRC 患者的分析表明，有 FH 的 CRC 患者的 OS 更好，但与无 FH 的 CRC 患者的癌症复发率相似。FH 对 OS 的影响独立于微卫星状态。需要进一步研究以确定潜在机制，并根据 FH 确定 CRC 的最佳临床管理。
