Lykke Jakob, Roikjaer Ole, Jess Per, Rosenberg Jacob
Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Department of Surgery, Zealand University Hospital, Roskilde, Denmark.
Ann Coloproctol. 2020 Oct;36(5):316-322. doi: 10.3393/ac.2019.03.03. Epub 2020 Feb 18.
This study aimed to identify possible patient- and tumor-related factors associated with risk of TNM stage III disease in nonmetastatic colon cancer.
The associations between stage III disease and age, sex, lymph node yield, pathological tumor (pT) stage, tumor subsite, type of surgery, and priority of surgery were assessed in a nationwide cohort of 13,766 patients treated with curative resection of colon cancer. Each level of age, lymph node yield, and pT stage was compared to the preceding level.
Age, lymph node yield, pT stage, tumor subsite, and priority of surgery were associated with stage III disease. Odds ratios (95% confidence interval [CI]) were as follows: age < 65/65-75 years: 1.28 (95% CI, 1.15-1.43) and 65-75/ > 75 years: 1.22 (95% CI, 1.13-1.32); lymph node yield 0-5/6-11: 0.60 (95% CI, 0.50-0.72), lymph node yield 6-11/12-17: 0.84 (95% CI, 0.76-0.93), and lymph node yield 12-17/ ≥ 18: 0.97 (95% CI, 0.89-1.05); pT1/pT2: 0.74 (95% CI, 0.57-0.95), pT2/pT3: 0.35 (95% CI, 0.30-0.40), and pT3/pT4: 0.49 (95% CI, 0.47-0.54). Only tumors of the transverse colon were independently associated with lower risk of stage III disease than tumors in the sigmoid colon (sigmoid colon: 1, transverse colon: 0.84 [95% CI, 0.73-0.96]; elective surgery: 1, acute surgery: 1.43 [95% CI, 1.29-1.60]).
In this study, stage III disease in colon cancer was significantly associated with age, lymph node yield, pT stage, tumor subsite, and priority of surgery but was not associated with right-sided location compared with stage I and II cancers.
本研究旨在确定非转移性结肠癌患者TNM III期疾病风险相关的可能的患者及肿瘤相关因素。
在全国范围内的13766例接受结肠癌根治性切除术的患者队列中，评估III期疾病与年龄、性别、淋巴结获取数量、病理肿瘤（pT）分期、肿瘤亚部位、手术类型及手术优先级之间的关联。将年龄、淋巴结获取数量及pT分期的每个水平与前一水平进行比较。
年龄、淋巴结获取数量、pT分期、肿瘤亚部位及手术优先级与III期疾病相关。比值比（95%置信区间[CI]）如下：年龄<65/65 - 75岁：1.28（95% CI，1.15 - 1.43），65 - 75/>75岁：1.22（95% CI，1.13 - 1.32）；淋巴结获取数量0 - 5/6 - 11：0.60（95% CI，0.50 - 0.72），淋巴结获取数量6 - 11/12 - 17：0.84（95% CI，0.76 - 0.93），淋巴结获取数量12 - 17/≥18：0.97（95% CI，0.89 - 1.05）；pT1/pT2：0.74（95% CI，0.57 - 0.95），pT2/pT3：0.35（95% CI，0.30 - 0.40），pT3/pT4：0.49（95% CI，0.47 - 0.54）。仅横结肠癌与III期疾病风险低于乙状结肠癌独立相关（乙状结肠癌：1，横结肠癌：0.84[95% CI，0.73 - 0.96]；择期手术：1，急诊手术：1.43[95% CI，1.29 - 1.60]）。
在本研究中，与I期和II期癌症相比，结肠癌III期疾病与年龄、淋巴结获取数量、pT分期、肿瘤亚部位及手术优先级显著相关，但与右侧位置无关。
