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对切除性结直肠癌肺小转移的新辅助疗法:一个回顾性队列研究

Yibo Cai¹, Guohui Xu², Yanxi Shao^1,3

¹Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.

International journal of colorectal disease

|August 28, 2025

概括

新辅助疗法 (NAT) 可以改善切除性结直肠癌肺小转移 (CRCPOM) 的患者的生存率. 临床风险评分确定了肺转移切除术前从NAT中获益最多的患者.

科学领域:

癌症学
外科瘤学
医学瘤学

背景情况:

肺转移切除是可切除结直肠癌肺小转移的标准.
新辅助治疗 (NAT) 在这种情况下的作用尚不清楚.

研究的目的:

评估新辅助疗法 (NAT) 是否改善可切除CRCPOM患者的生存结果.
确定生存预测因素并评估NAT的疗效.

主要方法:

对253名接受肺转移切除术的患者 (2010-2022) 的回顾性分析.
倾向性得分匹配 (PSM) 来平衡基线特征.
卡普兰-梅尔和考克斯回归分析无病存活 (DFS).

主要成果:

新辅助疗法 (NAT) 与PSM后的DFS改善有关 (HR为0. 52,P=0. 009).
通过临床风险评分 (CEA,无病区间,结节状况,肺外转移) 确定了受益于NAT的患者.
对NAT的RECIST定义反应与改善的DFS相关 (HR为0.31,P=0.008).

结论:

新辅助疗法 (NAT) 可能为切除CRCPOM提供生存益处.
具有至少一个风险因素的患者是初始NAT的合适候选人.
在肺转移切除之前,可以根据RECIST标准评估NAT的疗效.

关键词:

临床风险评分结直肠癌肺部小转移没有疾病的生存率肺转移切除术新辅助疗法

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