对非转移性pT4结肠腺癌患者的最佳治疗策略和预后分析
Xinyue Zhao1,2, Qinghong Meng2, Mengyun Zhou2
1Graduate School of Dalian Medical University, Dalian, China.
Frontiers in oncology
|January 23, 2024
概括
结合辅助治疗的手术显著改善了T4期结肠癌患者的生存率. 一个新的名图准确地预测了结果,帮助结肠腺癌 (COAD) 的个性化治疗策略.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症预后 癌症预后
背景情况:
- 结肠腺癌 (COAD) 带来了重大挑战,特别是在晚期如pT4M0.0.
- 最佳的治疗策略和准确的预后工具对于改善COAD患者的治疗结果至关重要.
研究的目的:
- 确定pT4M0结肠腺癌患者的最佳治疗策略.
- 开发和验证一种预后模型,用于预测pT4M0 COAD中的整体生存率 (OS) 和癌症特异性生存率 (CSS).
主要方法:
- 从SEER数据库 (2010-2015) 中分析了8843名pT4M0COAD患者的情况.
- 基于显著的预后因素,使用多变量COX回归编制名图的开发.
- 使用C指数,AUC,ROC和校准曲线验证名图.
主要成果:
- 与辅助治疗 (S+ADT) 进行的手术显示,与单独手术相比,3年后的生存率 (74.22% vs. 63.20%) 和CSS (76.25% vs. 66.98%) 显着更高.
- OS和CSS的关键预测因素包括年龄,种族,N阶段,血清CEA,分化,切除的淋巴结和治疗.
- 在训练套件中,名图实现了OS的0.692和CSS的0.690的C指数,并得到了强大的验证.
结论:
- 与手术结合的辅助化疗和放射治疗显著提高了pT4M0 COAD患者的长期存活率.
- 一个经过验证的纳米图,包括临床和病理因素,有助于预测OS和CSS.
- 这种预测工具可以帮助临床医生识别高风险患者,并为结肠癌量身定制个性化治疗计划.
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