Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Musashikosugi Hospital, Tokyo, Japan.
Surg Today. 2023 Aug;53(8):890-898. doi: 10.1007/s00595-023-02644-6. Epub 2023 Jan 27.
To investigate a prognostic score for stage II-III colorectal cancer (CRC) based on post-CEA and pT4 levels.
Two cohorts of stage II-III CRC patients who underwent curative surgery between 2011 and 2017 were included. The prognostic score (T-CEA score) was calculated as follows: T-CEA-0, post-CEA ≤ 5 ng/mL and pT1-3; T-CEA-1, post-CEA > 5 ng/mL or pT4; T-CEA-2, post-CEA > 5 ng/mL and pT4.
The T-CEA scores of the 587 patients were as follows: T-CEA-0 (n = 436; 74%), T-CEA-1 (n = 129; 22%), and T-CEA-2 (n = 10; 2%). The 5-year recurrence-free survival (RFS) rates of the T-CEA-0, 1, and 2 groups were 80.3%, 54.8%, and 0%, respectively (P < 0.01), and the 5-year overall survival (OS) rates were 90.9%, 74.2%, and 0%, respectively (T-CEA-0 vs T-CEA-1: P < 0.01, T-CEA-1 vs T-CEA-2: P = 0.04). Multivariate analysis revealed that an elevated T-CEA score of 1 or 2 was a significant risk factor for poor RFS (HR: 2.89, P < 0.01) and OS (HR: 2.85, P < 0.01).
The T-CEA score is a reliable and convenient prognostic score for stage II-III CRC.
基于癌胚抗原(CEA)术后水平和 pT4 来研究 II-III 期结直肠癌(CRC)的预后评分。
纳入 2011 年至 2017 年间接受根治性手术的 II-III 期 CRC 患者的两个队列。预后评分(T-CEA 评分)的计算方法如下:T-CEA-0,CEA 术后水平≤5ng/ml 且 pT1-3;T-CEA-1,CEA 术后水平>5ng/ml 或 pT4;T-CEA-2,CEA 术后水平>5ng/ml 且 pT4。
587 例患者的 T-CEA 评分如下:T-CEA-0(n=436;74%)、T-CEA-1(n=129;22%)和 T-CEA-2(n=10;2%)。T-CEA-0、1 和 2 组的 5 年无复发生存率(RFS)分别为 80.3%、54.8%和 0%(P<0.01),5 年总生存率(OS)分别为 90.9%、74.2%和 0%(T-CEA-0 与 T-CEA-1:P<0.01,T-CEA-1 与 T-CEA-2:P=0.04)。多因素分析显示,T-CEA 评分升高 1 分或 2 分是 RFS(HR:2.89,P<0.01)和 OS(HR:2.85,P<0.01)不良的显著危险因素。
T-CEA 评分是 II-III 期 CRC 可靠且方便的预后评分。