治療後の監視検査の強度と大腸がん患者の再発の検出との関連
Rebecca A Snyder1,2, Chung-Yuan Hu1, Amanda Cuddy1
1Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston.
JAMA
|May 26, 2018
まとめ
画像検査やCEA検査を用いた結腸直腸がん (CRC) の強化監視は,再発を検出する時間や患者の生存率に有意な影響を及ぼさなかった. これは,現在の監視の強さは,CRC患者の主要なアウトカムを変えないことを示唆しています.
科学分野:
- 腫瘍学
- 臨床研究
- 癌の監視
背景:
- 結腸直腸がん (CRC) の治療後の監視は標準的な慣行である.
- 再発の検出と患者の生存に対する監視の強度の影響は不明である.
研究 の 目的:
- 監視の強さとCRC再発の検出までの時間との関連を調査する.
- 監視の強さが再発率や患者の全生存率に影響するかどうかを判断する.
主な方法:
- 国立がんデータベースのデータを活用した遡及的なコホート研究.
- 2006~2007年に治療を受けた8529人のCRCの分析
- 施設レベルでの画像と癌胚性抗原 (CEA) 検査の頻度によって分類された監視の強度.
主要な成果:
- 画像検査またはCEA検査において,高強度および低強度監視グループ間の再発検出までの時間における有意な差は見つかりませんでした.
- 再発したCRCの切除率と全生存率は,監視の強度と有意に関連しませんでした.
- 症状の再発の検出までの平均時間は,異なる監視の強度で類似していました.
結論:
- 画像とCEA検査の頻度によって定義される監視の強さは,CRC患者における再発の早期発見と有意に関連していません.
- 現在の監視戦略は,再発率や全生存期に影響を与えないようです.
- 結腸直腸がんの監視プロトコルを最適化するために,さらなる研究が必要になる可能性があります.
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