广东医学
廣東醫學
엄동의학
GUNAGDONG MEDICAL JOURNAL
2010年
1期
69-71
,共3页
周仲国%伍小军%潘志忠%万德森%丁培荣%林俊忠%王福龙%彭志恒%张荣欣
週仲國%伍小軍%潘誌忠%萬德森%丁培榮%林俊忠%王福龍%彭誌恆%張榮訢
주중국%오소군%반지충%만덕삼%정배영%림준충%왕복룡%팽지항%장영흔
结直肠癌%Ⅱ期%高危因素%化疗
結直腸癌%Ⅱ期%高危因素%化療
결직장암%Ⅱ기%고위인소%화료
colorectal cancer%Ⅱ stage%high risk factor%chemotherapy
目的 分析影响Ⅱ期结直肠癌患者预后的高危因素,初步探讨具有高危因素的患者行辅助化疗的必要性.方法 对443例行结直肠癌根治术的Ⅱ期结直肠癌患者的临床病理资料进行统计,用Kaplan-Meier法计算生存率、绘制生存曲线.对高危因素进行Cox单因素和多因素模型分析,具有高危因素的患者再按有无辅助化疗分组分析、比较预后.结果 术前伴有肠梗阻或穿孔、送检淋巴结数少于12枚、T4分期、切缘小于1 cm是影响Ⅱ期结直肠癌患者预后的高危因素,分组分析显示术前伴有肠梗阻或穿孔、送检淋巴结数少于12枚、T4分期的Ⅱ期大肠癌患者行辅助化疗后总生存率高于未化疗者.结论 术前伴有肠梗阻或穿孔、送检淋巴结数少于12枚、T4分期、切缘小于1 cm是Ⅱ期结直肠癌患者预后不良的高危因素,具有前3种高危因素的患者可能从辅助化疗中获益.
目的 分析影響Ⅱ期結直腸癌患者預後的高危因素,初步探討具有高危因素的患者行輔助化療的必要性.方法 對443例行結直腸癌根治術的Ⅱ期結直腸癌患者的臨床病理資料進行統計,用Kaplan-Meier法計算生存率、繪製生存麯線.對高危因素進行Cox單因素和多因素模型分析,具有高危因素的患者再按有無輔助化療分組分析、比較預後.結果 術前伴有腸梗阻或穿孔、送檢淋巴結數少于12枚、T4分期、切緣小于1 cm是影響Ⅱ期結直腸癌患者預後的高危因素,分組分析顯示術前伴有腸梗阻或穿孔、送檢淋巴結數少于12枚、T4分期的Ⅱ期大腸癌患者行輔助化療後總生存率高于未化療者.結論 術前伴有腸梗阻或穿孔、送檢淋巴結數少于12枚、T4分期、切緣小于1 cm是Ⅱ期結直腸癌患者預後不良的高危因素,具有前3種高危因素的患者可能從輔助化療中穫益.
목적 분석영향Ⅱ기결직장암환자예후적고위인소,초보탐토구유고위인소적환자행보조화료적필요성.방법 대443례행결직장암근치술적Ⅱ기결직장암환자적림상병리자료진행통계,용Kaplan-Meier법계산생존솔、회제생존곡선.대고위인소진행Cox단인소화다인소모형분석,구유고위인소적환자재안유무보조화료분조분석、비교예후.결과 술전반유장경조혹천공、송검림파결수소우12매、T4분기、절연소우1 cm시영향Ⅱ기결직장암환자예후적고위인소,분조분석현시술전반유장경조혹천공、송검림파결수소우12매、T4분기적Ⅱ기대장암환자행보조화료후총생존솔고우미화료자.결론 술전반유장경조혹천공、송검림파결수소우12매、T4분기、절연소우1 cm시Ⅱ기결직장암환자예후불량적고위인소,구유전3충고위인소적환자가능종보조화료중획익.
Objective To identify the high risk factors in the prognosis of stage Ⅱ colorectal cancer, and analyze the necessity of adjuvant chemotherapy. Methods Four hundred and forty three patients with stage Ⅱ colon cancer who had received radical surgery in cancer center of Sun Yat-sen University were retrospectively analyzed. The overall survival rate and survival curve were analyzed with the Kaplan-Meier method and Log-rank test, respectively. The univariate and multivariate Cox regression model were applied for high risk factors analysis. For patients with high-risk factors, prognosis was compared between patients with or without adjuvant chemotherapy. Results Univariate and multivariate regression analysis revealed that preoperative intestinal obstruction or perforation, number of sampled nodes less than 12, T4 stage and inadequate surgical margin were independent unfavorable prognostic factors for patient survival with stage Ⅱ colorectal cancer. During subgroup analysis, patients with the first three high-risk factors had higher 3-year and 5-year overall survival with adjuvant chemotherapy. Conclusion Preoperative intestinal obstruction or perforation, number of sampled nodes less than 12, T4 stage and inadequate surgical margin were high-risk prognostic factors. Furhtermore, patients with the first three factors can benefit from adjuvant chemotherapy.
