Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
Int J Colorectal Dis. 2020 May;35(5):881-885. doi: 10.1007/s00384-020-03548-4. Epub 2020 Feb 28.
The diagnostic impact of lymphovascular invasion (LVI), perineural invasion (PNI), and tumor budding in stage I colon cancer is currently unknown. This study was conducted to evaluate the prognostic impact of LVI, PNI, and tumor budding in stage I colon cancer.
From January 2008 to December 2013, 720 patients who underwent curative surgery and were diagnosed with stage I colon cancer were reviewed retrospectively. These patients were categorized into two groups based on LVI, PNI, and tumor budding: the no risk group (n = 566) and risk group (n = 154).
Median follow-up period was 103.5 months, and the 5-year disease-free survival rate of the risk group was significantly lower than that of the no risk group (p = 0.025). In multivariate analysis, only the risk group had prognostic factors for 5-year disease-free survival (p = 0.036). In addition, only differentiation was an independent predictor in the risk group (p = 0.009).
LVI, PNI, and tumor budding are strong prognostic factors for stage I colon cancer. Therefore, patients with positive LVI, PNI, or tumor budding should receive close follow-up and potentially be considered for chemotherapy.
目前尚不清楚淋巴管浸润(LVI)、神经周围浸润(PNI)和肿瘤芽在 I 期结肠癌中的诊断影响。本研究旨在评估 LVI、PNI 和肿瘤芽在 I 期结肠癌中的预后影响。
回顾性分析 2008 年 1 月至 2013 年 12 月期间接受根治性手术且诊断为 I 期结肠癌的 720 例患者。根据 LVI、PNI 和肿瘤芽将这些患者分为两组:无风险组(n=566)和风险组(n=154)。
中位随访时间为 103.5 个月,风险组的 5 年无病生存率明显低于无风险组(p=0.025)。多因素分析显示,仅风险组是 5 年无病生存的预后因素(p=0.036)。此外,只有分化是风险组的独立预测因素(p=0.009)。
LVI、PNI 和肿瘤芽是 I 期结肠癌的强烈预后因素。因此,LVI、PNI 或肿瘤芽阳性的患者应接受密切随访,并可能考虑化疗。