Zheng Hang, Zhang Jixin, Liu Yucun, Wang Xin
Department of General Surgery, Peking University First Hospital, Peking University Health Science Center, 8 Xishku Street, 100034, Beijing, Xicheng District, P.R. China.
Department of Pathology, Peking University First Hospital, Peking University Health Science Center, 100034, Beijing, P.R. China.
Int J Clin Oncol. 2021 Jun;26(6):1109-1119. doi: 10.1007/s10147-021-01885-0. Epub 2021 Mar 19.
The actual risks posed by tumor deposits (TDs) in colorectal cancer are still incompletely assessed. We explored the prognostic value of TDs in locally advanced rectal cancer (LARC) patients using propensity score matching (PSM) method.
Consecutive LARC patients in Peking University First Hospital between 2011 and 2015 were retrospectively analyzed. Kaplan-Meier methods and Cox proportional hazard regression analysis were conducted to explore prognostic values of TDs. PSM method was conducted to minimize selection bias. The correlation between TDs number and prognosis was explored.
Four hundred and fifty-one LARC patients were recruited, and 78 (17.3%) patients were with TDs. Multivariate Cox analysis identified that the presence of TDs was an independent prognostic risk factor for overall survival (OS) (P = 0.044). PSM identified 76 matched pairs of LARC patients, and Kaplan-Meier curves revealed that patients with TDs experienced worse OS (log-rank P = 0.0220) and relapse-free survival (RFS) (log-rank P = 0.0117). Subgroup analysis of 50 pairs extracted by PSM from 246 LARC patients with lymph node metastasis (LNM) further proved that TDs were significantly associated with worse OS (log-rank P = 0.0415), and the association was barely significant for RFS (log-rank P = 0.0527). There were non-significant tendencies towards higher mortality in TDs ≥ 2 than TD = 1 group (log-rank P = 0.348 for OS, log-rank P = 0.087 for RFS).
Our study manifested that the presence of TDs was an independent risk factor for LARC patients. The prognostic value of TDs for LARC patients with LNM should not be ignored.
结直肠癌中肿瘤沉积物（TDs）所带来的实际风险仍未得到充分评估。我们使用倾向评分匹配（PSM）方法探讨了TDs在局部晚期直肠癌（LARC）患者中的预后价值。
对2011年至2015年期间北京大学第一医院的连续LARC患者进行回顾性分析。采用Kaplan-Meier方法和Cox比例风险回归分析来探讨TDs的预后价值。采用PSM方法以尽量减少选择偏倚。探讨了TDs数量与预后之间的相关性。
共纳入451例LARC患者，其中78例（17.3%）患者存在TDs。多因素Cox分析确定，TDs的存在是总生存期（OS）的独立预后危险因素（P = 0.044）。PSM确定了76对匹配的LARC患者，Kaplan-Meier曲线显示，存在TDs的患者OS较差（对数秩检验P = 0.0220），无复发生存期（RFS）也较差（对数秩检验P = 0.0117）。从246例有淋巴结转移（LNM）的LARC患者中通过PSM提取的50对亚组分析进一步证明，TDs与较差的OS显著相关（对数秩检验P = 0.0415），而与RFS的相关性勉强显著（对数秩检验P = 0.0527）。TDs≥2组的死亡率高于TD = 1组，但差异无统计学意义（OS的对数秩检验P = 0.348，RFS的对数秩检验P = 0.087）。
我们的研究表明，TDs的存在是LARC患者的独立危险因素。TDs对有LNM的LARC患者的预后价值不容忽视。
