肿瘤沉积物与非转移性结直肠癌患者腹膜疾病的风险增加相关。
Tumor deposits are associated with a higher risk of peritoneal disease in non-metastatic colorectal cancer patients.
机构信息
Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
出版信息
J Surg Oncol. 2023 May;127(6):975-982. doi: 10.1002/jso.27207. Epub 2023 Feb 15.
BACKGROUND AND OBJECTIVES
Tumor deposit (TD) is a poor prognostic factor in colorectal cancer (CRC) patients. This study aimed to determine whether TD carry the same risk of peritoneal recurrence as known high-risk (HR) features in CRC patients.
METHODS
A retrospective cohort-study of stage I-III CRC patients from 2010 to 2015 was conducted. TD group was defined by the presence of TD on histopathology whereas HR group was defined by the presence of obstruction, perforation, or T4-stage.
RESULTS
A total of 151 patients with CRC were identified, of which 50 had TD and 101 had a HR feature. The overall risk of peritoneal recurrence was higher in the TD group versus HR group (36.0% vs. 19.8%, p = 0.03). The risk of peritoneum as the site of first recurrence was also higher in the TD group (22.0% vs. 12.9%, p = 0.03). Overall cancer recurrence at any site was also higher in the TD group (56.0% vs. 34.7%, p = 0.01). Median time to first recurrence was 1.2 (0.7-1.9) years in the TD group compared to 1.4 (0.8-2.1) years in the HR group (p = 0.31).
CONCLUSIONS
In non-metastatic CRC patients, TD might have a higher risk of tumor recurrence versus their HR counterparts. Alternative strategies for surveillance and treatment should be considered.
背景与目的
肿瘤沉积物（TD）是结直肠癌（CRC）患者预后不良的一个因素。本研究旨在确定 TD 是否与 CRC 患者已知的高危（HR）特征具有相同的腹膜复发风险。
方法
对 2010 年至 2015 年期间的 I-III 期 CRC 患者进行回顾性队列研究。TD 组定义为组织病理学上存在 TD，而 HR 组定义为存在梗阻、穿孔或 T4 期。
结果
共确定了 151 例 CRC 患者，其中 50 例存在 TD，101 例存在 HR 特征。TD 组的总体腹膜复发风险高于 HR 组（36.0% vs. 19.8%，p=0.03）。TD 组腹膜作为首次复发部位的风险也更高（22.0% vs. 12.9%，p=0.03）。TD 组任何部位的总体癌症复发率也更高（56.0% vs. 34.7%，p=0.01）。TD 组首次复发的中位时间为 1.2（0.7-1.9）年，而 HR 组为 1.4（0.8-2.1）年（p=0.31）。
结论
在非转移性 CRC 患者中，TD 可能比其 HR 对应物具有更高的肿瘤复发风险。应考虑采用替代策略进行监测和治疗。
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