伴有肿瘤沉积的I - III期结肠癌患者的表现与IV期患者相似。对392例患者进行横断面分析。

Stage I-III colon cancer patients with tumor deposits behave similarly to stage IV patients. Cross-section analysis of 392 patients.

作者信息

Lino-Silva Leonardo S, Anchondo-Núñez Patricia, Chit-Huerta Alonso, Aguilar-Romero Estefanía, Morales-Soto Jonathan, Salazar-García Jenny A, Guzmán-López Cristina J, Maldonado-Martínez Héctor A, Meneses-García Abelardo, Salcedo-Hernández Rosa A

机构信息

Surgical Pathology, Instituto Nacional de Cancerología, Mexico, Mexico.

AFINES Program, Medicine Faculty, Mexico's National Autonomus University, Mexico, Mexico.

出版信息

J Surg Oncol. 2019 Aug;120(2):300-307. doi: 10.1002/jso.25482. Epub 2019 Apr 24.

DOI:10.1002/jso.25482

PMID:31017669

Abstract

BACKGROUND AND OBJECTIVES

Tumor deposits (TDs) are associated with adverse prognostic factors and decreased survival in colorectal cancer. However, controversy exists regarding their definition, evaluation, and staging categories. This study aimed to determine the survival and recurrence impact of the TD in colon adenocarcinomas; and to determine if TD patients behave similarly to stage IV patients.

METHODS

Cross-section study from 392 patients with colon adenocarcinoma from 2005 to 2012. We performed survival analysis and further stratified patients considering TD patients as a "stage IV-TD" to demonstrate if they behave similarly than stage IV patients.

RESULTS

From 392 patients, 204 (52%) were men, the mean age was 57.4 ± 13.9 years and 11.5% of cases had TD. In a multivariate analysis, TD failed to predict mortality and recurrence. Considering cases with TD as stage IV-TD, their mean survival was similar to stage IV patients (69.3 and 64.6 months, respectively) and different to those in stage III (110.5 months), II (135.7 months), and I (114.9 months) (P < 0.001).

CONCLUSIONS

TD failed to predict mortality and recurrence. Patients with TD in stage I-III shows similar mortality than stage IV patients; then, we suggest putting them into a substage IV category instead of the N1c category.

摘要

背景与目的

肿瘤结节（TDs）与结直肠癌的不良预后因素及生存率降低相关。然而，关于其定义、评估及分期类别仍存在争议。本研究旨在确定TDs对结肠腺癌患者生存及复发的影响；并确定TD患者的表现是否与IV期患者相似。

方法

对2005年至2012年的392例结肠腺癌患者进行横断面研究。我们进行了生存分析，并将TD患者视为“IV期-TD”对患者进行进一步分层，以证明他们的表现是否与IV期患者相似。

结果

392例患者中，204例（52%）为男性，平均年龄为57.4±13.9岁，11.5%的病例有TDs。在多因素分析中，TDs未能预测死亡率和复发率。将有TDs的病例视为IV期-TD，其平均生存期与IV期患者相似（分别为69.3个月和64.6个月），与III期（110.5个月）、II期（135.7个月）和I期（114.9个月）患者不同（P<0.001）。