Mucinous histology predicts for poor response rate and overall survival of patients with colorectal cancer and treated with first-line oxaliplatin- and/or irinotecan-based chemotherapy.
Mucinous histology predicts for poor response rate and overall survival of patients with colorectal cancer and treated with first-line oxaliplatin- and/or irinotecan-based chemotherapy.
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DOI：
10.1038/sj.bjc.6604955
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发表时间：
2009-03-24
影响因子：
8.8
通讯作者：
Fedeli, S. L.
中科院分区：
文献类型：
--
作者：
Catalano, V.;Loupakis, F.;Graziano, F.;Torresi, U.;Bisonni, R.;Mari, D.;Fornaro, L.;Baldelli, A. M.;Giordani, P.;Rossi, D.;Alessandroni, P.;Giustini, L.;Silva, R. R.;Falcone, A.;D'Emidio, S.;Fedeli, S. L.
本研究的目的是探讨含有伊立替康和/或奥沙利铂的一线化疗对晚期粘液性结直肠癌患者的疗效。使用单变量和多变量 Logistic 和/或 Cox 比例风险分析确定与缓解率和生存相关的预后因素。该人群包括 255 名患者，其中 49 名（19%）患有粘液性结直肠癌，206 名（81%）患有非粘液性结直肠癌。粘液性肿瘤和非粘液性肿瘤的总体缓解率分别为 18.4 (95% CI, 7.5–29.2%) 和 49% (95% CI, 42.2–55.8%) (P=0.0002)。中位随访 45 个月后，粘液性患者的中位总生存期为 14.0 个月，而非粘液性患者的中位总生存期为 23.4 个月（风险比 (HR)，1.74；CI 95%，1.27–3.31；P=0.0034）。通过多变量 Cox 回归分析调整显着特征后，粘液组织学与较差的总生存率（HR，1.593，95% CI，1.05-2.40；P=0.0267）以及体能状态 ECOG 2、转移部位数量⩾2 和腹膜转移相关。本回顾性分析显示，与非粘液性结直肠癌患者相比，粘液性结直肠癌患者对以奥沙利铂/伊立替康为基础的一线联合化疗反应较差，预后较差。
The objective of this study was to investigate the efficacy of first-line chemotherapy containing irinotecan and/or oxaliplatin in patients with advanced mucinous colorectal cancer. Prognostic factors associated with response rate and survival were identified using univariate and multivariate logistic and/or Cox proportional hazards analyses. The population included 255 patients, of whom 49 (19%) had mucinous and 206 (81%) had non-mucinous colorectal cancer. The overall response rates for mucinous and non-mucinous tumours were 18.4 (95% CI, 7.5–29.2%) and 49% (95% CI, 42.2–55.8%), respectively (P=0.0002). After a median follow-up of 45 months, median overall survival for the mucinous patients was 14.0 months compared with 23.4 months for the non-mucinous group (hazard ratio (HR), 1.74; CI 95%, 1.27–3.31; P=0.0034). After adjustment for significant features by multivariate Cox regression analysis, mucinous histology was associated with poor overall survival (HR, 1.593, 95% CI, 1.05–2.40; P=0.0267), together with performance status ECOG 2, number of metastatic sites ⩾2, and peritoneal metastases. This retrospective analysis shows that patients with mucinous colorectal cancer have poor responsiveness to oxaliplatin/irinotecan-based first-line combination chemotherapy and an unfavourable prognosis compared with non-mucinous colorectal cancer patients.
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