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肺癌结直肠转移的临床病理特征:日本文献病例报告的系统评价

Clinicopathological characteristics of colorectal metastases from lung cancer: systematic review of the case reports in the Japanese literature.

作者信息

Kikuchi Yoshinori, Shimada Hideaki, Isobe Kazutoshi, Shimizu Ryo, Wakabayashi Munehiro, Yamaguchi Kazuhisa, Igarashi Yoshinori

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan.

Department of Gastroenterological Surgery and Clinical Oncology, Toho University Graduate School of Medicine, Tokyo, Japan.

出版信息

Int Cancer Conf J. 2021 Jul 19;10(4):266-273. doi: 10.1007/s13691-021-00502-1. eCollection 2021 Oct.

Abstract

Since colorectal metastases from primary lung cancer are rare, the location of metastatic lesion and prognostic factors have not been well evaluated. Therefore, we carried out a systematic review and meta-analysis to assess the clinicopathological characteristics and prognostic factors of Japanese patients with colorectal metastasis from lung cancer. We searched the Ichushi-Web database from January 1964 to December 2020. We found 59 colorectal metastases in 52 cases for this meta-analysis. Small cell carcinoma was shown to have significantly more metastases to the appendix than non-small cell carcinoma. However, there was no significant correlation between location and histology when classified into right and left colons ( = 0.247). The median overall survival after diagnosis was 6 months. Univariate analysis showed that adenocarcinoma (Hazard Ratio (HR) 0.383,  = 0.024), simultaneous metastasis (HR 0.325,  = 0.046), and chemotherapy group (HR 0.482,  = 0.044) were good prognostic factors. Multivariate analysis confirmed that chemotherapy (HR 0.38,  = 0.02) was an independent good prognostic factor for overall survival. In conclusion, although there was no statistical difference, right colon metastases were more frequent than left colon metastases. Chemotherapy may be effective for colorectal metastases from lung cancer.

摘要

由于原发性肺癌的结直肠转移较为罕见,转移病灶的位置及预后因素尚未得到充分评估。因此,我们进行了一项系统评价和荟萃分析,以评估日本肺癌结直肠转移患者的临床病理特征及预后因素。我们检索了1964年1月至2020年12月的Ichushi-Web数据库。我们发现52例中有59处结直肠转移用于此项荟萃分析。结果显示,小细胞癌的阑尾转移显著多于非小细胞癌。然而,按左右结肠分类时,位置与组织学之间无显著相关性(P = 0.247)。诊断后的中位总生存期为6个月。单因素分析显示,腺癌(风险比(HR)0.383,P = 0.024)、同时性转移(HR 0.325,P = 0.046)和化疗组(HR 0.482,P = 0.044)是良好的预后因素。多因素分析证实,化疗(HR 0.38,P = 0.02)是总生存期的独立良好预后因素。总之,尽管无统计学差异,但右半结肠转移比左半结肠转移更常见。化疗可能对肺癌的结直肠转移有效。

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