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长期新辅助放化疗后局部进展期中低位直肠癌患者不同淋巴结分期的比较

Comparison of Different Nodal Staging in Patients With Locally Advanced Mid-low Rectal Cancer After Long-term Neoadjuvant Chemoradiation Therapy.

作者信息

Petrucciani Niccolò, Carra Maria Clotilde, Martínez-Pérez Aleix, Vitali Giulio Cesare, Landi Filippo, Genova Pietro, Memeo Riccardo, Brunetti Francesco, Espin Eloy, Ris Frederic, De'angelis Nicola

机构信息

Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.

Rothschild Hospital, AP-HP, Paris VII University, Paris, France.

出版信息

Anticancer Res. 2019 Apr;39(4):2113-2120. doi: 10.21873/anticanres.13324.


DOI:10.21873/anticanres.13324
PMID:30952757
Abstract

BACKGROUND/AIM: The aim of this study was to compare the ability of different lymph nodal staging systems to predict cancer recurrence in a multicenter European series of patients who underwent proctectomy after neoadjuvant chemoradiotherapy for locally advanced rectal cancer. PATIENTS AND METHODS: Data on 170 consecutive patients undergoing proctectomy after neoadjuvant therapy for cT3-4 or cN+ rectal adenocarcinoma were retrieved from the European MRI and Rectal Cancer Surgery database. The prognostic role of the number of retrieved and examined nodes, nodal ratio, and log odds of positive lymph nodes (LODDS) was analyzed and compared by receiver operating characteristic curves, Pearson test, and univariate and multivariate analysis. RESULTS: At multivariate analysis, ypN, nodal ratio, and LODDS were all significantly associated with disease-free survival, but LODDS showed the strongest association (hazard ratio(HR)=2.39; 95% confidence interval(CI)=1.05-5.48; p=0.039). CONCLUSION: LODDS appears to be a useful prognostic indicator in the prediction of disease-free survival of patients undergoing neoadjuvant chemoradiotherapy and proctectomy for locally advanced rectal cancer.

摘要

背景/目的:本研究旨在比较不同淋巴结分期系统对欧洲多中心系列局部晚期直肠癌患者新辅助放化疗后行直肠切除术预测癌症复发的能力。 患者与方法:从欧洲MRI与直肠癌手术数据库中检索170例接受新辅助治疗的cT3-4或cN+直肠腺癌患者行直肠切除术的数据。通过受试者工作特征曲线、Pearson检验以及单因素和多因素分析,对获取和检查的淋巴结数量、淋巴结比率以及阳性淋巴结对数优势比(LODDS)的预后作用进行分析和比较。 结果:多因素分析显示,ypN、淋巴结比率和LODDS均与无病生存期显著相关,但LODDS显示出最强的相关性(风险比(HR)=2.39;95%置信区间(CI)=1.05-5.48;p=0.039)。 结论:对于接受新辅助放化疗和直肠切除术的局部晚期直肠癌患者,LODDS似乎是预测无病生存期的有用预后指标。

相似文献

[1]
Comparison of Different Nodal Staging in Patients With Locally Advanced Mid-low Rectal Cancer After Long-term Neoadjuvant Chemoradiation Therapy.

Anticancer Res. 2019-4

[2]
Prognostic value of metastatic lymph node regression grade after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer.

Surgery. 2019-7-23

[3]
The effect of adjuvant chemotherapy on survival and recurrence after curative rectal cancer surgery in patients who are histologically node negative after neoadjuvant chemoradiotherapy.

Colorectal Dis. 2017-11

[4]
The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer.

Colorectal Dis. 2014-1

[5]
What To Do With Lateral Nodal Disease in Low Locally Advanced Rectal Cancer? A Call for Further Reflection and Research.

Dis Colon Rectum. 2017-6

[6]
Long-Term Outcome of Rectal Cancer With Clinically (EUS/MRI) Metastatic Mesorectal Lymph Nodes Treated by Neoadjuvant Chemoradiation: Role of Organ Preservation Strategies in Relation to Pathologic Response.

Ann Surg Oncol. 2016-12

[7]
[Retrospective study of role of neoadjuvant rectal scores in evaluating the 10-year disease-free survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy followed by surgery].

Zhonghua Wei Chang Wai Ke Za Zhi. 2024-6-25

[8]
[Evaluation of progression-free survival for locally advanced rectal cancer by MRI after neoadjuvant chemoradiotherapy and total mesorectal excision].

Zhonghua Zhong Liu Za Zhi. 2018-2-23

[9]
Impact of residual nodal involvement after complete tumor response in patients undergoing neoadjuvant (chemo)radiotherapy for rectal cancer.

Surgery. 2019-8-1

[10]
Prognostic Impact of Lymph Node Ratio in Patients Undergoing Preoperative Chemoradiotherapy Followed by Curative Resection for Locally Advanced Rectal Cancer.

In Vivo. 2020

引用本文的文献

[1]
The survival prediction of advanced colorectal cancer received neoadjuvant therapy-a study of SEER database.

World J Surg Oncol. 2024-7-1

[2]
Log odds of positive lymph nodes show better predictive performance on the prognosis of early-onset colorectal cancer.

Int J Colorectal Dis. 2023-7-11

[3]
Impact of Systematic Holistic Nursing Combined with Narrative Nursing Intervention for Patients with Advanced Gastric Cancer on Complications and Negative Emotions.

Evid Based Complement Alternat Med. 2022-7-15

[4]
A prognostic nomogram for stage II/III rectal cancer patients treated with neoadjuvant chemoradiotherapy followed by surgical resection.

BMC Surg. 2022-7-4

[5]
Prognostic Nomogram for Rectal Cancer Patients With Tumor Deposits.

Front Oncol. 2022-2-2

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