在现代,全国性基于人口的队列中,直肠癌手术后复发的危险因素
Sepehr Doroudian1,2,3, Erik Osterman4,5, Bengt Glimelius4
1Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. sepehr.doroudian@regiongavleborg.se.
Annals of surgical oncology
|June 9, 2024
概括
准确预测直肠癌的风险对于有效治疗至关重要. 瘤阶段和沉积等关键因素显著影响复发,从而使个性化监测策略成为可能.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症研究 癌症研究
背景情况:
- 对直肠癌的多式疗法需要精确的风险预测,以获得最佳的结果.
- 了解与手术前治疗,病理阶段和已知的因素相关的复发风险对于辅助治疗和监测决策至关重要.
研究的目的:
- 确定直肠癌患者局部区域和远程复发的重大风险因素.
- 评估这些风险因素对不同新辅助治疗组的影响.
- 评估当代直肠癌管理中随时可用的风险因素的持续有效性.
主要方法:
- 利用瑞典色直肠癌登记 (2011-2018) 获取患者数据.
- 采用Cox的比例危险模型来分析复发风险因素.
- 包括患者,瘤和治疗变量作为分析中的暴露.
主要成果:
- 分析了9428,治疗性切除的直肠腺癌患者,随访时间中位数为72个月.
- 确定了pT4a,pN2b,瘤沉积物,淋巴结产量和瘤水平作为远端复发的主要风险因素.
- 证明病理阶段和风险因素的数量在新辅助疗法组之间显著区分复发风险.
结论:
- 随时可用的危险因素仍然是复发的强有力的预测因素,在所有新辅助治疗环境中补充病态阶段.
- 瘤沉积是一个关键因素,而环切除边缘可能在先进的手术技术下不那么重要.
- 使用阶段和确定的因素进行风险分层,可以在特定患者队伍中定制监测策略.
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