辅助化疗对T4 N0结肠癌患者有好处吗?
Goncagul Akdag1, Deniz Isik1, Akif Dogan1
1Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, 34865 Istanbul, Turkey.
Medicina (Kaunas, Lithuania)
|August 29, 2024
概括
辅助化疗显著改善了T4结肠癌患者的无疾病生存率和整体生存率. 淋巴血管侵袭也是一个关键的预后因素,增加死亡风险.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 结肠直肠癌 (CRC) 构成了全球严重的健康负担.
- 对高风险CRC,特别是II期CRC的最佳辅助治疗策略仍在争论中.
- 结肠癌T4需要特定的预后因素识别.
研究的目的:
- 评估辅助化疗对T4结肠癌无疾病生存期 (DFS) 和整体生存期 (OS) 的影响.
- 确定影响T4结肠癌患者结果的预后因素.
主要方法:
- 对184名pT4 pN0结肠癌患者进行了彻底手术的回顾性分析 (2002-2023年).
- 多变量分析以评估辅助化疗和淋巴血管侵入 (LVI) 对生存结果的影响.
主要成果:
- 79.3%的患者接受了辅助化疗.
- 辅助化疗与疾病进展风险 (DFS) 的60%降低有关 (HR:0.40,p < 0.001).
- 辅助治疗使死亡率降低了60% (OS) (HR: 0.40,p = 0.001),而LVI使死亡率增加了1.9倍 (HR: 1.94,p = 0.011).
结论:
- 辅助化疗是T4结肠癌的显著积极预后因素.
- 淋巴血管侵袭是这个患者群体中一个关键的负面预后因素.
- 这些发现支持T4结肠癌患者使用辅助化疗.
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