Pinto João Cortez, Rosa Isadora, Martins Catarina, Marques Inês, da Silva João Pereira, Fonseca Ricardo, Freire João, Pereira António Dias
Serviço de Gastrenterologia, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE, 1099-023, Lisbon, Portugal.
Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG) EPE, 1099-023, Lisbon, Portugal.
J Gastrointest Cancer. 2020 Mar;51(1):116-120. doi: 10.1007/s12029-019-00218-9.
To determine prognostic factors for stage IIA colon cancer (CC) recurrence in patients undergoing curative intent surgery without adjuvant treatment.
Single-centre cohort study. All patients with stage IIA CC discussed in a multidisciplinary colorectal cancer clinic from January 2010 to December 2012 were evaluated. Clinical data, laboratory data and tumour features, including expression of DNA repair proteins (EDRP), were analysed. Assessment of overall and disease free survival, recurrence, recurrence site and recurrence's method of diagnosis was performed. The associations between variables were tested through the Fisher's exact test (SPSS 23).
Fifty-five patients were included (55% male gender; mean age at diagnosis was 70.3 years (42-88)). CC was in the left colon in 62%, high grade in 7% and had lymphovascular invasion in 7% of the cases. Only one patient was submitted to emergent surgery for obstructive symptoms. In 55% of cases ≥ 12 lymph nodes were collected. There was EDRP loss in nine patients (MLH1/PMS2: six; MSH2/MSH6: three)-only two fulfilled revised Bethesda criteria. Recurrence occurred in five patients (8.9%), and it was diagnosed through surveillance in all of them. No variable showed a statistically significant association with recurrence; however, there were no recurrences in patients with EPRD loss (p = 0.209). Mean follow-up time was 43 months (2-70). In those with recurrence, mean disease-free survival was 23.4 months.
The overall good prognosis and absence of recurrence predictive factors were confirmed, validating the decision of not to submit stage IIA CC patients to chemotherapy risks.
确定未接受辅助治疗的根治性手术患者中ⅡA期结肠癌（CC）复发的预后因素。
单中心队列研究。对2010年1月至2012年12月在多学科结直肠癌诊所讨论的所有ⅡA期CC患者进行评估。分析临床数据、实验室数据和肿瘤特征，包括DNA修复蛋白（EDRP）的表达。评估总生存期和无病生存期、复发情况、复发部位及复发的诊断方法。通过Fisher精确检验（SPSS 23）检测变量之间的关联。
纳入55例患者（男性占55%；诊断时平均年龄为70.3岁（42 - 88岁））。62%的CC位于左半结肠，7%为高级别，7%的病例有淋巴管侵犯。仅1例患者因梗阻症状接受急诊手术。55%的病例收集到≥12枚淋巴结。9例患者存在EDRP缺失（MLH1/PMS2：6例；MSH2/MSH6：3例），仅2例符合修订的贝塞斯达标准。5例患者（8.9%）出现复发，均通过监测诊断。无变量与复发有统计学显著关联；然而，EDRP缺失的患者未出现复发（p = 0.209）。平均随访时间为43个月（2 - 70个月）。复发患者的平均无病生存期为23.4个月。
证实了总体良好的预后及缺乏复发预测因素，验证了不使ⅡA期CC患者承受化疗风险这一决策的合理性。
