Sameh Hany Emile , Nir Horesh , Zoe Garoufalia , Rachel Gefen , Victor Strassmann , Steven D. Wexner
{"title":"对结肠 Signet-Ring 细胞癌 II-III 期辅助疗法生存结果的倾向分数匹配分析","authors":"Sameh Hany Emile , Nir Horesh , Zoe Garoufalia , Rachel Gefen , Victor Strassmann , Steven D. Wexner","doi":"10.1016/j.clcc.2023.10.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p><span>Colonic signet ring cell carcinoma (SRCC) is a </span>mucinous adenocarcinoma subtype often associated with poor prognosis. This study assessed the survival benefits of adjuvant therapy after curative resection of stage II-III colonic SRCC.</p></div><div><h3>Methods</h3><p>This was a retrospective analysis of outcomes of adjuvant therapy in colonic SRCC using National Cancer Database (2010-2019) data. Patients who received adjuvant therapy were matched to those who did not use the nearest neighbor propensity-score matching. The primary outcome was 5-year overall survival (OS).</p></div><div><h3>Results</h3><p><span>The unmatched cohort included 3530 patients. Patients who received adjuvant therapy were significantly younger, more often male, and more often had Charlson scores 0-1, left-sided cancers, stage III disease, lymphovascular invasion<span>, and perineural invasion. The matched cohort included 958 patients (53.6% female); 479 received adjuvant therapy and 479 did not. Adjuvant therapy was associated with longer mean OS (39.9 vs. 29.2 months; </span></span><em>P</em> < .001)<strong>.</strong> Survival benefit of adjuvant therapy was evident in stage III disease (37.5 vs. 24.7 months; <em>P</em><span> < .001), right-sided colon cancer (40.2 vs. 27.7 months; </span><em>P</em><span> < .001), and transverse colon cancer (40.6 vs. 31.1 months; </span><em>P</em> = .002), but not stage II disease (52.1 vs. 53.1 months; <em>P</em> = .694) or left-sided colon cancer (35.8 vs. 32.6 months; <em>P</em> = .417). Independent predictors of improved OS were adjuvant therapy (HR: 0.539; <em>P</em><span> < .001), laparoscopic surgery (HR: 0.829; </span><em>P</em> = .001), robotic-assisted surgery (HR: 0.63; <em>P</em> = .007), and number of harvested lymph nodes (HR: 0.976; <em>P</em> < .001).</p></div><div><h3>Conclusions</h3><p>Adjuvant therapy was associated with improved OS in stage III, right-sided, and transverse colon SRCC. The survival benefit of adjuvant therapy in stage II and left-sided colon SRCC was limited.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"23 1","pages":"Pages 35-45"},"PeriodicalIF":3.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Propensity-Score Matched Analysis of Survival Outcomes of Adjuvant Therapy in Stage II-III Signet-Ring Cell Carcinoma of the Colon\",\"authors\":\"Sameh Hany Emile , Nir Horesh , Zoe Garoufalia , Rachel Gefen , Victor Strassmann , Steven D. Wexner\",\"doi\":\"10.1016/j.clcc.2023.10.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p><span>Colonic signet ring cell carcinoma (SRCC) is a </span>mucinous adenocarcinoma subtype often associated with poor prognosis. This study assessed the survival benefits of adjuvant therapy after curative resection of stage II-III colonic SRCC.</p></div><div><h3>Methods</h3><p>This was a retrospective analysis of outcomes of adjuvant therapy in colonic SRCC using National Cancer Database (2010-2019) data. Patients who received adjuvant therapy were matched to those who did not use the nearest neighbor propensity-score matching. The primary outcome was 5-year overall survival (OS).</p></div><div><h3>Results</h3><p><span>The unmatched cohort included 3530 patients. Patients who received adjuvant therapy were significantly younger, more often male, and more often had Charlson scores 0-1, left-sided cancers, stage III disease, lymphovascular invasion<span>, and perineural invasion. The matched cohort included 958 patients (53.6% female); 479 received adjuvant therapy and 479 did not. Adjuvant therapy was associated with longer mean OS (39.9 vs. 29.2 months; </span></span><em>P</em> < .001)<strong>.</strong> Survival benefit of adjuvant therapy was evident in stage III disease (37.5 vs. 24.7 months; <em>P</em><span> < .001), right-sided colon cancer (40.2 vs. 27.7 months; </span><em>P</em><span> < .001), and transverse colon cancer (40.6 vs. 31.1 months; </span><em>P</em> = .002), but not stage II disease (52.1 vs. 53.1 months; <em>P</em> = .694) or left-sided colon cancer (35.8 vs. 32.6 months; <em>P</em> = .417). Independent predictors of improved OS were adjuvant therapy (HR: 0.539; <em>P</em><span> < .001), laparoscopic surgery (HR: 0.829; </span><em>P</em> = .001), robotic-assisted surgery (HR: 0.63; <em>P</em> = .007), and number of harvested lymph nodes (HR: 0.976; <em>P</em> < .001).</p></div><div><h3>Conclusions</h3><p>Adjuvant therapy was associated with improved OS in stage III, right-sided, and transverse colon SRCC. 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引用次数: 0
摘要
背景结肠标志环细胞癌(SRCC)是一种粘液腺癌亚型,通常预后较差。这项研究评估了II-III期结肠SRCC根治性切除术后辅助治疗的生存益处。方法这是一项利用国家癌症数据库(2010-2019年)数据对结肠SRCC辅助治疗结果进行的回顾性分析。采用近邻倾向分数匹配法将接受辅助治疗的患者与未接受辅助治疗的患者进行匹配。主要结果是5年总生存率(OS)。接受辅助治疗的患者明显更年轻、更多为男性、更多为查尔森评分0-1分、左侧癌症、III期疾病、淋巴管侵犯和神经周围侵犯。配对队列包括 958 名患者(53.6% 为女性),其中 479 人接受了辅助治疗,479 人未接受辅助治疗。辅助治疗与更长的平均生存期有关(39.9 个月 vs. 29.2 个月;P < .001)。辅助治疗对 III 期疾病(37.5 个月 vs. 24.7 个月;P < .001)、右侧结肠癌(40.2 个月 vs. 27.7 个月;P < .001)和横结肠癌(40.6 个月 vs. 31.1 个月;P = .002)的生存获益明显,但对 II 期疾病(52.1 个月 vs. 53.1 个月;P = .694)或左侧结肠癌(35.8 个月 vs. 32.6 个月;P = .417)的生存获益不明显。辅助治疗(HR:0.539;P = .001)、腹腔镜手术(HR:0.829;P = .001)、机器人辅助手术(HR:0.63;P = .007)和收获淋巴结数量(HR:0.976;P = .001)是改善OS的独立预测因素。辅助治疗对II期和左侧结肠SRCC的生存获益有限。
Propensity-Score Matched Analysis of Survival Outcomes of Adjuvant Therapy in Stage II-III Signet-Ring Cell Carcinoma of the Colon
Background
Colonic signet ring cell carcinoma (SRCC) is a mucinous adenocarcinoma subtype often associated with poor prognosis. This study assessed the survival benefits of adjuvant therapy after curative resection of stage II-III colonic SRCC.
Methods
This was a retrospective analysis of outcomes of adjuvant therapy in colonic SRCC using National Cancer Database (2010-2019) data. Patients who received adjuvant therapy were matched to those who did not use the nearest neighbor propensity-score matching. The primary outcome was 5-year overall survival (OS).
Results
The unmatched cohort included 3530 patients. Patients who received adjuvant therapy were significantly younger, more often male, and more often had Charlson scores 0-1, left-sided cancers, stage III disease, lymphovascular invasion, and perineural invasion. The matched cohort included 958 patients (53.6% female); 479 received adjuvant therapy and 479 did not. Adjuvant therapy was associated with longer mean OS (39.9 vs. 29.2 months; P < .001). Survival benefit of adjuvant therapy was evident in stage III disease (37.5 vs. 24.7 months; P < .001), right-sided colon cancer (40.2 vs. 27.7 months; P < .001), and transverse colon cancer (40.6 vs. 31.1 months; P = .002), but not stage II disease (52.1 vs. 53.1 months; P = .694) or left-sided colon cancer (35.8 vs. 32.6 months; P = .417). Independent predictors of improved OS were adjuvant therapy (HR: 0.539; P < .001), laparoscopic surgery (HR: 0.829; P = .001), robotic-assisted surgery (HR: 0.63; P = .007), and number of harvested lymph nodes (HR: 0.976; P < .001).
Conclusions
Adjuvant therapy was associated with improved OS in stage III, right-sided, and transverse colon SRCC. The survival benefit of adjuvant therapy in stage II and left-sided colon SRCC was limited.
期刊介绍:
Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.