Department of Colorectal Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangdong, 510060, Guangzhou, P. R. China.
Department of Thyroid and Breast Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, 518000, Shenzhen, P. R. China.
BMC Cancer. 2023 Jan 3;23(1):3. doi: 10.1186/s12885-022-10416-7.
BACKGROUND: Lymphovascular invasion (LVI) and perineural invasion (PNI) can indicate poor survival outcomes in colorectal cancer, but few studies have focused on stage III colon cancer. The current study aimed to confirm the prognostic value of LVI and PNI and identify patients who could benefit from a complete duration of adjuvant chemotherapy based on the two pathological factors. METHODS: We enrolled 402 consecutive patients with stage III colon cancer who received colon tumor resection from November 2007 to June 2016 at Sun Yat-sen University Cancer Center. Survival analyses were performed by using Kaplan-Meier method with log-rank tests. Risk factors related to disease-free survival (DFS) and overall survival (OS) were identified through Cox proportional hazards analysis. RESULTS: 141 (35.1%) patients presented with LVI, and 108 (26.9%) patients with PNI. The LVI-positive group was associated with poorer 3-year DFS (86.5% vs. 76.3%, P = 0.001) and OS (96.0% vs. 89.1%, P = 0.003) rates compared with the LVI-negative group. The PNI-positive group showed a worse outcome compared with the PNI-negative group in 3-year DFS rate (72.5% vs. 86.7%, P < 0.001). Moreover, LVI-positive group present better 3-year DFS and OS rate in patients completing 6-8 cycles of adjuvant chemotherapy than those less than 6 cycles (3-year DFS: 80.0% vs. 64.9%, P = 0.019; 3-year OS: 93.2% vs. 76.3%, P = 0.002). CONCLUSIONS: LVI is a superior prognostic factor to PNI in stage III colon cancer patients undergoing curative treatment. PNI status can noly predict the 3-year DFS wihout affecting the 3-year OS. Furthermore, LVI also represents an effective indicator for adjuvant chemotherapy duration.
背景：淋巴血管侵犯（LVI）和神经周围侵犯（PNI）可提示结直肠癌患者的生存结局较差，但很少有研究关注 III 期结肠癌。本研究旨在确认 LVI 和 PNI 的预后价值，并基于这两个病理因素确定哪些患者可能从完整的辅助化疗持续时间中获益。
方法：我们纳入了 2007 年 11 月至 2016 年 6 月在中山大学肿瘤防治中心接受结肠癌肿瘤切除术的 402 例连续 III 期结肠癌患者。使用 Kaplan-Meier 方法和对数秩检验进行生存分析。通过 Cox 比例风险分析确定与无病生存（DFS）和总生存（OS）相关的危险因素。
结果：141 例（35.1%）患者存在 LVI，108 例（26.9%）患者存在 PNI。与 LVI 阴性组相比，LVI 阳性组的 3 年 DFS（86.5% vs. 76.3%，P=0.001）和 OS（96.0% vs. 89.1%，P=0.003）率较差。与 PNI 阴性组相比，PNI 阳性组的 3 年 DFS 率（72.5% vs. 86.7%，P<0.001）较差。此外，在接受 6-8 个周期辅助化疗的患者中，LVI 阳性组的 3 年 DFS 和 OS 率优于接受少于 6 个周期化疗的患者（3 年 DFS：80.0% vs. 64.9%，P=0.019；3 年 OS：93.2% vs. 76.3%，P=0.002）。
结论：在接受根治性治疗的 III 期结肠癌患者中，LVI 是比 PNI 更好的预后因素。PNI 状态仅能预测 3 年 DFS，而不影响 3 年 OS。此外，LVI 也是辅助化疗持续时间的有效指标。
Medicine (Baltimore). 2020-4
World J Gastrointest Oncol. 2024-10-15
Dis Colon Rectum. 2019-10
Gastroenterol Rep (Oxf). 2019-6
World J Gastroenterol. 2019-5-28
Zotero 插件
