结直肠癌N期后肿瘤沉积的预后分析

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2025-03-06 DOI:10.1016/j.suronc.2025.102203

Tanasit Saikeaw, Phadungkiat Tipmanee, Pasut Chareonpornwattana, Gritcharat Watthanasathitarpha, Kanyanat Dasom, Thitithep Limvorapitak

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引用次数: 0

摘要

肿瘤沉积（TD）已被证明对诊断为结直肠癌（CRC）的患者具有预后影响，尽管与区域淋巴结转移相比，它们的影响似乎不大。患者和方法回顾性分析了2015年1月至2019年12月期间在泰国三级医疗中心接受治愈性切除术的I-III期结直肠癌患者。这些患者被分为两组：TD阳性和TD阴性。并将患者分为N0、N1、N2组。比较无病生存期和总生存期。结果1015例患者中，176例（17.3%）有肿瘤沉积（TD）， 374例（36.8%）有淋巴结（LN）阳性。与TD阴性组相比，TD阳性组的5年总生存率（OS）和5年无病生存率（DFS）显著降低(73.5% vs 85.9%, p <；0.001和72.5% vs 87.9%, p <；0.001分别)。根据不同的N分期进行分层，N1组TD的存在与DFS显著相关（5年DFS: 84.3%对89.2%,p = 0.006）。多因素logistic分析显示，TD是疾病复发的独立预测因子[p = 0.02；风险比（HR）：1.71（1.11-2.64）。结论TD的存在与结直肠癌患者总生存期（OS）和无病生存期（DFS）的降低显著相关，尤其是结直肠癌淋巴结转移患者。

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The prognostic outcome of tumor deposit in colorectal cancer beyond stage N staging

Background

Tumor deposits (TD) have been shown to have prognostic implications in patients diagnosed with colorectal cancer (CRC), although their impact appears to be modest compared to regional lymph node metastases.

Patients and methods

A retrospective analysis was conducted involving patients with colorectal cancer in stages I-III who underwent curative resections between January 2015 and December 2019 in the tertiary care center in Thailand. These patients were divided into two cohorts: TD positive and TD negative. Additionally, the patients were subsequently classified into N0, N1, and N2 groups. Disease-free survival and overall survival were compared.

Results

Among the 1015 eligible patients, 176 (17.3 %) had tumor deposits (TD), while 374 patients (36.8 %) had positive lymph nodes (LN). The TD positive group demonstrated a significantly lower 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) compared to the TD negative group (73.5 % vs 85.9 %, p < 0.001 and 72.5 % vs 87.9 %, p < 0.001 respectively). Upon stratification by various N stages, the presence of TD was notably associated with DFS in the N1 group (5-year DFS: 84.3 % vs. 89.2 %, p = 0.006). Multivariate logistic analyses shown TD as an independent predictor of disease recurrence [p = 0.02; hazard ratio (HR):1.71 (1.11–2.64)].

Conclusion

The presence of TD was significantly correlated with reduced overall survival (OS) and disease-free survival (DFS) in colorectal cancer, especially in patients with nodal metastases.

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.