瘤沉积物不应置于TNM的M类:使用SEER数据进行比较生存分析
Ayse Selcen Oguz Erdogan1, Femke Simmer1, Iris D Nagtegaal1
1Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
International journal of cancer
|September 5, 2024
概括
结直肠癌患者的瘤沉积 (TD) 对存活率产生负面影响. 这项研究发现,尽管预后不好,但TD不需要重新分类到第四阶段,因为TD的第三阶段患者比第四阶段患者的情况更好.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 临床病理学 临床病理学
背景情况:
- 瘤沉积 (TD) 是结节在结直肠癌 (CRC) 患者的淋巴排水.
- 目前在TNM分期中被归类为N类,TD与预后不佳有关.
- 之前的小型研究建议将TD重新归类为M类.
研究的目的:
- 评估瘤沉积 (TD) 在第三和第四阶段结肠癌 (CC) 的预后影响.
- 根据生存结果,评估TD是否应该重新归类为M类.
- 分析TD和没有TD的III期和IV期CC患者之间的生存差异.
主要方法:
- 对监测,流行病学和最终结果 (SEER) 计划数据的回顾性分析.
- 包括52,332名被诊断为III期和IV期结肠癌 (CC) 的患者.
- 多变量分析以确定TD对生存的独立预后影响.
主要成果:
- 在第三阶段 (HR=1.4) 和第四阶段 (HR=1.3) CC.中,TD显著和负面地影响了生存率.
- 患有TD的III期CC患者的五年整体存活率 (OS) 为49%,而没有TD的患者为64% (p<.001).
- 在TD患者的IV期CC患者中,五年后的生存率为10%和21% (p<.001).
- 第三阶段的TD的CC患者 (5年OS 49%) 的预后明显好于第四阶段的患者 (5年OS 17%,p<.001).
结论:
- 瘤沉积 (TD) 是第三阶段和第四阶段结肠癌的显著负面预后因素.
- 尽管他们的预后不好,但数据不支持将TD重新分类到第四阶段.
- 与第四阶段患者相比,患有TD的第三阶段结肠癌患者的生存结果更好.
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