Michiels C, Boutron M C, Chatelain N, Quipourt V, Roy P, Faivre J
Registre Bourguignon des Tumeurs Digestives, Faculté de Médecine de Dijon.
Gastroenterol Clin Biol. 1994;18(5):456-61.
A study of prognostic factors in Dukes B colorectal adenocarcinoma was performed on a population basis in order to determine subgroups with poor prognosis which could benefit from adjuvant therapy after surgery. The study considered the 746 cases of Dukes B colorectal carcinoma diagnosed during the 1976-1988 period among Côte-d'Or residents (Burgundy, France). The overall 5-year crude survival rate was 55.7%, the corresponding relative survival rate being 73%. In the final Cox model, age, tumour extension to adjacent organs, number of examined lymph nodes and tumour size were significant prognostic factors. The corresponding multivariate relative survival model considered only tumour extension and number of examined lymph nodes as having a prognostic value. The relative risk of death was 2.3 (range: 1.5-3.3) in case of a tumor extension and 2.5 (range: 1.5-4.4) when no lymph node was found compared to surgical samples with at least 6 lymph nodes. These data should be taken into account when conceiving or analyzing future therapeutic trials.
为了确定预后较差、可从术后辅助治疗中获益的亚组，我们基于人群对Dukes B期结直肠癌的预后因素进行了一项研究。该研究纳入了1976年至1988年期间在法国勃艮第科多尔省居民中诊断出的746例Dukes B期结直肠癌病例。总体5年粗生存率为55.7%，相应的相对生存率为73%。在最终的Cox模型中，年龄、肿瘤向邻近器官的浸润、检查的淋巴结数量和肿瘤大小是显著的预后因素。相应的多变量相对生存模型仅认为肿瘤浸润和检查的淋巴结数量具有预后价值。与至少有6个淋巴结的手术样本相比，肿瘤浸润时死亡的相对风险为2.3（范围：1.5 - 3.3），未发现淋巴结时为2.5（范围：1.5 - 4.4）。在设计或分析未来的治疗试验时应考虑这些数据。
