肿瘤消退等级是否足以预测食管癌三模式治疗的生存率?

IF 2.1 4区医学 Q2 SURGERY

Journal of Investigative Surgery Pub Date : 2022-11-01 Epub Date: 2022-09-27 DOI:10.1080/08941939.2022.2127036

Yi-Min Gu, Si-Mian Lyu, Qi-Xin Shang, Han-Lu Zhang, Yu-Shang Yang, Wen-Ping Wang, Yong Yuan, Long-Qi Chen

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引用次数: 0

摘要

背景:本研究旨在评估肿瘤消退等级(TRG)和淋巴结状态对食管癌新辅助放化疗(nCRT)患者生存的预测价值。方法:观察肿瘤病理消退及淋巴结状态。采用Kaplan-Meier法和log-rank检验分析按TRG或淋巴结状态分层的生存差异。采用单因素和多因素Cox比例风险法分析TRG和淋巴结状态的预后价值。结果:2016年7月至2019年6月，253例食管癌患者接受了nCRT后手术治疗。不同淋巴结状态的生存率有显著差异，但TRG无显著差异。多因素分析显示，淋巴结状态而非TRG是总生存的唯一独立预测因素(HR: 3.550, 95% CI: 2.264-5.566, P P)。结论:淋巴结状态比TRG对食管癌行nCRT +食管切除术患者生存的影响更重要。改良后的TRG系统有助于术后治疗决策和生存监测。

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Is Tumor Regression Grade Sufficient to Predict Survival in Esophageal Cancer with Trimodal Therapy?

Background: This study aimed to assess the predictive value of tumor regression grade (TRG) and nodal status on survival in esophageal carcinoma with neoadjuvant chemoradiotherapy (nCRT).

Methods: Tumor pathologic regression and nodal status were assessed. Differences in survival stratified by TRG or nodal status were analyzed using the Kaplan-Meier method and log-rank test. The prognostic value of TRG and nodal status were analyzed using univariate and multivariate Cox proportional hazards methods.

Results: From July 2016 to June 2019, 253 patients with esophageal cancer underwent nCRT followed by surgery. Significant differences were presented in survival according to nodal status but not TRG. Multivariate analysis showed that nodal status and not TRG was the only independent predicter for overall survival (HR: 3.550, 95% CI: 2.264-5.566, P < 0.001) and disease-free survival (HR: 2.801, 95% CI: 1.874-4.187, P < 0.001). The modified TRG system combining tumor regression with nodal status stratified patients survival with good discrimination.

Conclusions: Lymph node status impacts more importantly than TRG on survival for patients with esophageal cancer undergoing nCRT plus esophagectomy. The modified TRG system may facilitate postoperative treatment decisions and survival surveillance.

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来源期刊

Journal of Investigative Surgery 医学-外科

CiteScore

4.20

自引率

0.00%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.