[日本结直肠癌分类第9版中Ⅱ期和Ⅲ期切除结直肠癌的预后及辅助化疗检查]

[Examination of Prognosis and Adjuvant Chemotherapy in Stage Ⅱ and Stage Ⅲ Resected Colorectal Cancer in the 9th Edition Japanese Classification of Colorectal Carcinoma].

作者信息

Morikawa Mitsuhiro, Azuma Kyouhei, Naruse Takayuki, Kurebayashi Hidetaka, Sawai Katsuji, Koneri Kenji, Tamaki Masato, Murakami Makoto, Hirono Yasuo, Maeda Hiroyuki, Goi Takanori

机构信息

Dept. of First Surgery, University of Fukui.

出版信息

Gan To Kagaku Ryoho. 2020 Aug;47(8):1264-1267.

PMID:32829370

Abstract

In the 9th edition Japanese Classification of Colorectal Carcinoma, Stage Ⅱ and Stage Ⅲ colorectal cancer(CRC)were subdivided by TNM classification on invasion and number of lymph node metastases. We studied prognostic comparison and relation of adjuvant chemotherapy at the new classification. We included 400 cases with resected Ⅱ and Ⅲ CRC from 2007 to 2014. Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc were 97/68/20/24/124/67 cases. Adjuvant chemotherapy was performed at 19/32/45/66/59/70% in Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc, with or without adjuvant chemotherapy at each stage survival rates were compared. In Ⅱa/Ⅱb/Ⅱc, DSS was 97/97/82% and DFS was 89/88/76%, and the prognosis of Ⅱc was significantly worse. In Ⅲa/Ⅲb/Ⅲc, DSS was 95/86/57% and DFS was 82/77/41%. By the presence or absence of adjuvant chemotherapy, significantly differences were obtained at Ⅲb and Ⅲc. Prognosis of Ⅱc was almost same as Ⅲb, and prognosis of Ⅲa was almost same as Ⅱb. Therefore, we considered adjuvant chemotherapy with oxaliplatin should be performed to Ⅱc, Ⅲb, and Ⅲc.

摘要

在第9版日本结直肠癌分类中，Ⅱ期和Ⅲ期结直肠癌（CRC）根据TNM分类，依据浸润情况和淋巴结转移数量进行了细分。我们研究了新分类下辅助化疗的预后比较及相关性。我们纳入了2007年至2014年期间400例接受手术切除的Ⅱ期和Ⅲ期CRC患者。Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc期分别为97/68/20/24/124/67例。Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc期接受辅助化疗的比例分别为19%/32%/45%/66%/59%/70%，比较了各期无论是否接受辅助化疗的生存率。在Ⅱa/Ⅱb/Ⅱc期，疾病特异性生存率（DSS）分别为97%/97%/82%，无病生存率（DFS）分别为89%/88%/76%，Ⅱc期的预后明显较差。在Ⅲa/Ⅲb/Ⅲc期，DSS分别为95%/86%/57%，DFS分别为82%/77%/41%。根据是否接受辅助化疗，Ⅲb期和Ⅲc期有显著差异。Ⅱc期的预后与Ⅲb期几乎相同，Ⅲa期的预后与Ⅱb期几乎相同。因此，我们认为Ⅱc期、Ⅲb期和Ⅲc期应进行奥沙利铂辅助化疗。