新辅助放化疗后直肠癌患者的临床病理和分子特征的预后意义。
Prognostic Significance of Clinicopathological and Molecular Features After Neoadjuvant Chemoradiotherapy in Rectal Cancer Patients.
机构信息
Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Kyungpook National University Cancer Research Institute, Daegu, Republic of Korea.
Department of Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
出版信息
In Vivo. 2019 Nov-Dec;33(6):1959-1965. doi: 10.21873/invivo.11691.
BACKGROUND/AIM: This study evaluated clinicopathological and molecular features and their prognostic impact on patients with locally advanced rectal cancer (LARC) who received preoperative chemoradiotherapy (CRT).
PATIENTS AND METHODS
We retrospectively gathered data from 284 patients with LARC who underwent total mesorectal excision (TME) after CRT.
RESULTS
In the univariate analysis, lower yield pathologic T (ypT) category, yield pathologic N (ypN) category, yield pathologic TNM (ypTNM) stage, as well as the absence of lymphovascular invasion (LVI) and perineural invasion (PNI), were significantly associated with better disease-free survival (DFS) and overall survival (OS). Meanwhile, the expression of Ki-67, p53, and the mismatch repair (MMR) status showed no association with clinical outcomes. A multivariate survival analysis revealed that ypT category and LVI were independent prognostic factors of a worse DFS (HR=3.081, p-value=0.001; HR=2.818, p-value=0.030) and OS (HR=3.158, p-value=0.006; HR=3.837, p-value=0.014).
CONCLUSION
The ypT category and the presence of LVI were found to be prognostic factors for patients with LARC after CRT followed by TME.
背景/目的：本研究评估了接受术前放化疗（CRT）的局部晚期直肠癌（LARC）患者的临床病理和分子特征及其对预后的影响。
患者和方法
我们回顾性收集了 284 例接受 CRT 后行全直肠系膜切除术（TME）的 LARC 患者的数据。
结果
在单因素分析中，较低的肿瘤病理学 T 分期（ypT）类别、肿瘤病理学 N 分期（ypN）类别、肿瘤病理学 TNM 分期（ypTNM）以及无淋巴血管侵犯（LVI）和神经侵犯（PNI）与更好的无病生存（DFS）和总生存（OS）显著相关。同时，Ki-67、p53 的表达以及错配修复（MMR）状态与临床结果无关。多因素生存分析显示，ypT 分期和 LVI 是 DFS（HR=3.081，p 值=0.001；HR=2.818，p 值=0.030）和 OS（HR=3.158，p 值=0.006；HR=3.837，p 值=0.014）较差的独立预后因素。
结论
ypT 分期和 LVI 的存在被发现是 CRT 后接受 TME 的 LARC 患者的预后因素。
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