瘤大小对T3N1期结肠癌患者的预后影响
Ezgi Turkoglu1, Nisanur Sarıyar Busery1, Sedat Yildirim1
1Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, 34865 İstanbul, Türkiye.
Journal of clinical medicine
|January 10, 2026
概括
瘤大小影响结肠癌复发. 对于T3N1阶段的结肠癌患者来说,4厘米或更大的瘤与更差的无复发存活率有关,但不是总体存活率. 这一发现可能会改进分期和治疗决策.
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:
- 结肠癌的TNM分期缺乏瘤大小的纳入.
- 结肠癌中瘤大小的预后意义仍在争论中.
研究的目的:
- 评估瘤大小对无复发生存率 (RFS) 和整体生存率 (OS) 的影响.
- 评估T3N1期结肠癌患者的预后价值.
主要方法:
- 对336名接受治疗切除的pT3N1结肠癌患者的回顾性分析.
- 病理性瘤大小测量和ROC分析,以获得最佳的切断.
- 卡普兰-梅尔和考克斯回归用于预后因素识别.
主要成果:
- 针对复发预测的最佳瘤大小截止值为4厘米.
- 瘤≥4厘米与显著较低的5年RFS相关 (65.1%与80.3%,p=0.007).
- 瘤大小≥4厘米,ECOGPS≥2,阳性边际和不完全的辅助化疗是不良RFS预后因素. 瘤大小没有影响OS (p=0.46). 辅助化疗改善了RFS和OS (p<0.001).
结论:
- 瘤大小≥4厘米是T3N1阶段结肠癌中RFS的独立不良预后因素.
- 将瘤大小纳入风险分层可能会提高预后准确性.
- 考虑瘤大小,TNM分期和治疗完成,以改善临床决策.
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