评估结肠癌患者 D3 淋巴腺切除术后辅助化疗的益处：倾向得分匹配研究。

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2024-11-18 DOI:10.1007/s00595-024-02965-0

Kiyoaki Sugiura, Kensuke Takebe, Junya Aoyama, Go Oshima, Hiroto Kikuchi, Koji Okabayashi, Satoshi Aiko, Yuko Kitagawa

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引用次数: 0

摘要

目的：III期疾病的辅助化疗（AC）是公认的标准治疗方法，也是结肠癌（CC）患者的常规治疗方法。然而，对 AC 的建议主要基于过去环境下的研究，当时并未常规进行 D3 淋巴腺切除术：我们回顾性分析了庆应义塾监测流行病学和最终结果（K-SEER）数据库中接受根治性切除术并行 D3 淋巴腺切除术的 CC 患者。将患者分为AC组和非AC组后，对两组患者进行倾向得分匹配（PSM）：结果：经过倾向得分匹配，每组有 84 名患者。AC 组和非 AC 组的 5 年癌症特异性生存率（CSS；88.01% vs. 81.46%，P = 0.295）和 5 年无复发生存率（RFS；69.57 vs. 70.08%，P = 0.820）分别无明显差异。在亚组分析中，与非 AC 相比，AC 只改善了 N2 病变肿瘤的 CSS[危险比（HR）0.273；95% 置信区间（CI）0.094-0.797，p = 0.017]和 RFS（HR 0.376；95% CI 0.174-0.806，p = 0.012）：结论：D3淋巴结切除术后的CC患者应重新考虑目前的AC适应症。结论：D3淋巴结切除术后的CC患者目前的AC适应症应重新考虑，AC可能只适用于N2病变的III期CC患者。

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The assessment of adjuvant chemotherapy benefits after D3 lymphadenectomy in patients with colon cancer: a propensity score matching study.

Purpose: Adjuvant chemotherapy (AC) for stage III disease is recognized as a standard treatment and is routinely performed in patients with colon cancer (CC). However, the recommendation for AC is mainly based on studies performed in past environments, where D3 lymphadenectomy was not routinely performed.

Methods: We retrospectively analyzed CC patients who underwent curative resection with D3 lymphadenectomy in Keio Surveillance Epidemiology and End Results (K-SEER) database. After patients were divided into AC and non-AC groups, propensity score matching (PSM) was performed to match the two groups.

Results: After PSM, 84 patients were included in each group. There were no significant differences between the AC and non-AC groups in the 5-year cancer-specific survival (CSS; 88.01% vs. 81.46%, p = 0.295) and 5-year recurrence-free survival (RFS; 69.57 vs. 70.08%, p = 0.820), respectively. In the subgroup analysis, AC improved both the CSS [hazard ratio (HR)0.273; 95% confidence interval (CI) 0.094-0.797, p = 0.017] and RFS (HR 0.376; 95% CI 0.174-0.806, p = 0.012) only for tumors with N2 disease compared to non-AC.

Conclusion: The current indications for AC in patients with CC after D3 lymphadenectomy should be reconsidered. It is possible that AC is appropriate only for stage III CC patients with N2 disease.

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.