单体切除 IIC 期（pT4bN0）结肠癌患者的生存预后：回顾性观察队列研究

IF 3.2 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2024-05-24 DOI:10.1016/j.clcc.2024.05.005

Juliette Logeart , Thomas Samaille , Antoine Falcoz , Magali Svrcek , Olivier Dubreuil , Dewi Vernerey , Romain Cohen , Pascale Cervera , Alain Valverde , Yann Parc , Thierry André

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引用次数: 0

摘要

背景II期结肠癌（CC）在预后方面表现出相当大的异质性。我们的目的是评估微卫星不稳定性（MSI）对 IIC 期（T4bN0M0）结肠癌患者的生存期和预后的影响。主要终点为总生存期（OS），次要终点为无病生存期（DFS）和复发时间（TTR）。结果共纳入66例患者，中位年龄为74岁[30-95岁]，37.9%的患者出现MSI（n = 25）。器官侵犯涉及最后一个回肠襻（17 例）、另一个结肠段（15 例）、网膜（13 例）、内脏腹膜（13 例）和膀胱（4 例）。手术质量标准显示，所有患者都进行了完整的单体切除，93.9%的患者进行了R0切除。中位随访5年[3.5-6.6]后，所有患者的5年OS为65.2%[53.0-80.3]，5年DFS为53.5%[41.1-69.6]，18.9%[6.8-29.4]的患者5年后复发。MSI表型与5年OS改善相关（75.5% [56.5-100] vs. 59.5% [44.9-79.0], HR 0.41 [0.17-0.99]; P = .04），但DFS和TTR没有差异。34.9%的患者接受了辅助化疗。单变量分析显示，年龄 65 岁、MSI 状态和结节数量与 OS 相关。

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Survival Outcomes in Patients with Monobloc-Resected Stage IIC (pT4bN0) Colon Cancer: A Retrospective Observational Cohort Study

Background

Stage II colon cancer (CC) exhibits considerable prognostic heterogeneous. Our objective was to assess survival but also the prognosis impact of microsatellite instability (MSI) in patients with stage IIC (T4bN0M0) CC.

Patients and Methods

We conducted a retrospective observational study including all patients who had primary stage IIC CC resection between 2010 and 2020 in 2 expert centers. The primary endpoint was overall survival (OS) and disease-free survival (DFS) and time-to-relapse (TTR) were secondary endpoints.

Results

Sixty-six patients, median age of 74 years [30-95], were included, with 37.9% presenting MSI (n = 25). Organ invasion involved the last ileal loop (n = 17), another colonic segment (n = 15), omentum (n = 13), visceral peritoneum (n = 13), and the bladder (n = 4). Surgical quality criteria showed complete monobloc resection in all patients and 93.9% R0 resection. After a median follow-up of 5 years [3.5-6.6], the entire population showed a 5-year OS of 65.2% [53.0-80.3] and 5-year DFS of 53.5% [41.1-69.6], with 18.9% [6.8-29.4] experiencing relapses at 5 years. The MSI phenotype correlated with improved 5-year OS (75.5% [56.5-100] vs. 59.5% [44.9-79.0], HR 0.41 [0.17-0.99]; P = .04), but DFS and TTR did not differ. Adjuvant chemotherapy was administered to 34.9% of patients. Univariate analysis identified age > 65 years, MSI status, and the number of nodes as factors associated with OS.

Conclusion

These data underline, in relation to a low rate of relapse, the lack of consensus regarding the appropriate indication for adjuvant chemotherapy in this high-risk stage II population.

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

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.