Donato N, Dario C, Giovanni S, Virgilio B, Paolo D P, Roberto L, Gianfranco P, Mario L, Daniela P, Angelo T
Clinica Chirurgica II, Università degli Studi, Padova, Italy.
Eur J Surg Oncol. 1994 Aug;20(4):454-60.
As a means of defining the role of chemotherapy after radical resection of colorectal liver metastases, a follow-up study of consecutive cases referred to three different surgical clinics, between June 1977 and December 1990 was performed. Data were collected from medical records and recorded on standardized forms. Analysis focused on the impact of treatment on survival of the study population by Cox multivariate analysis. One hundred and twenty-four primary colon cancer cases were reviewed and 102 were fully evaluable. Forty of the 102 were given 5FU based chemotherapy. According to multivariate survival analysis, time to hepatic metastasis (synchronous vs metachronous, RR = 0.41, 95%, C.I. = 0.21-0.78; P = 0.007) and sex (female vs male, RR = 0.48, 95% C.I. = 0.25-0.93; P = 0.029) were significantly associated with better survival. The relative risk of dying associated with treatment was 0.53 (95% C.I. = 0.27-1.05; P = 0.0675). This study suggests that chemotherapy may have an impact on survival, although the size of the effect is not precise. Multicentric randomized clinical trials are required to define the risk/benefit profile of adjuvant chemotherapy.
作为确定结直肠癌肝转移根治性切除术后化疗作用的一种方法，我们对1977年6月至1990年12月期间转诊至三家不同外科诊所的连续病例进行了一项随访研究。数据从病历中收集并记录在标准化表格上。通过Cox多变量分析，重点分析治疗对研究人群生存的影响。回顾了124例原发性结肠癌病例，其中102例可进行全面评估。102例中的40例接受了以5-氟尿嘧啶为基础的化疗。根据多变量生存分析，肝转移时间（同时性与异时性，RR = 0.41，95%置信区间 = 0.21 - 0.78；P = 0.007）和性别（女性与男性，RR = 0.48，95%置信区间 = 0.25 - 0.93；P = 0.029）与更好的生存显著相关。与治疗相关的死亡相对风险为0.53（95%置信区间 = 0.27 - 1.05；P = 0.0675）。本研究表明化疗可能对生存有影响，尽管影响的程度尚不准确。需要进行多中心随机临床试验来确定辅助化疗的风险/获益情况。
