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癌胚抗原倍增时间在局部复发性直肠癌根治性切除术后预后预测中的应用:一项回顾性研究

Usefulness of Carcinoembryonic Antigen Doubling Time in Prognosis Prediction after Curative Resection of Locally Recurrent Rectal Cancer: A Retrospective Study.

作者信息

Sakamoto Junichi, Ozawa Heita, Nakanishi Hiroki, Fujita Shin

机构信息

Department of Colorectal Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.

出版信息

Dig Surg. 2022;39(1):17-23. doi: 10.1159/000520694. Epub 2021 Nov 8.

Abstract

INTRODUCTION

Given that doubling time is an indicator of tumor growth, we assessed the usefulness of carcinoembryonic antigen doubling time (CEA-DT) in prognosis prediction after curative resection for locally recurrent rectal cancer.

METHODS

During January 1986-December 2016, 33 patients with locally recurrent rectal cancer who underwent curative resection at our hospital were retrospectively reviewed. The primary endpoint was the 3-year recurrence-free survival (RFS) rate. The Kaplan-Meier method was used to compare RFS rates and evaluate univariate and multivariate analyses for factors associated with oncologic outcomes, including CEA-DT. CEA-DT was classified into 2 groups: the short and long CEA-DT groups.

RESULTS

The 3-year overall survival and RFS rates were 62.6% and 42.4%, respectively. In multivariate analyses, CEA-DT was an independent risk factor for poor RFS. The 3-year RFS rate was significantly better in the long CEA-DT group than in the short CEA-DT group (58.8% vs. 25.0%, p = 0.0063).

CONCLUSION

CEA-DT is a useful prognostic factor that can be assessed before surgery for locally recurrent rectal cancer. Long CEA-DT may indicate a favorable prognosis. Contrarily, short CEA-DT is associated with poor prognosis; therefore, further treatment intervention is necessary for patients with short CEA-DT.

摘要

引言

鉴于倍增时间是肿瘤生长的一个指标,我们评估了癌胚抗原倍增时间(CEA-DT)在局部复发性直肠癌根治性切除术后预后预测中的作用。

方法

回顾性分析1986年1月至2016年12月期间在我院接受根治性切除的33例局部复发性直肠癌患者。主要终点是3年无复发生存(RFS)率。采用Kaplan-Meier法比较RFS率,并对包括CEA-DT在内的与肿瘤学结局相关的因素进行单因素和多因素分析。CEA-DT分为两组:CEA-DT短组和CEA-DT长组。

结果

3年总生存率和RFS率分别为62.6%和42.4%。在多因素分析中,CEA-DT是RFS不良的独立危险因素。CEA-DT长组的3年RFS率显著高于CEA-DT短组(58.8%对25.0%,p = 0.0063)。

结论

CEA-DT是一种有用的预后因素,可在局部复发性直肠癌手术前进行评估。CEA-DT长可能预示预后良好。相反,CEA-DT短与预后不良相关;因此,对于CEA-DT短的患者需要进一步的治疗干预。

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