Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery
Adjuvant Chemotherapy for Small Bowel Adenocarcinoma after Curative Surgery
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DOI：
10.1159/000328506
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发表时间：
2011-01-01
期刊：
影响因子：
3.5
通讯作者：
Kim, Tae Won
中科院分区：
文献类型：
--
作者：
Koo, Dong Hoe;Yun, Sung-Cheol;Kim, Tae Won
目的：评估影响无复发生存期（RFS）和总生存期（OS）的预后因素，探讨辅助化疗在小肠腺癌（SBA）患者中的作用。方法：回顾性分析1989年1月至2009年12月在峨山医院行根治性手术的52例SBA患者的资料。患者分为两组：接受辅助化疗的（n = 23）和未接受辅助化疗的（n = 29）。结果：中位随访32.2个月（范围5.5-212.2个月），复发17例（32.7%），5年RFS率为52.9% (95% CI, 39.3-66.5%)，死亡19例（36.5%），5年OS率为59.0% （95% CI, 45.6-72.4%）。最常见的复发部位是腹膜和肝脏。多因素分析显示，淋巴结受累是与RFS和OS差独立相关的唯一因素。调整治疗权重逆概率后，辅助化疗并未提高RFS[风险比（HR）， 1.399；95% CI, 0.498-3.933]或OS （HR 0.797; 95% CI, 0.307-2.068）。结论：淋巴结受累是行根治性手术的SBA患者预后不良的一个预测因素。巴塞尔S. Karger股份有限公司版权所有
Objectives: We evaluated prognostic factors affecting relapse-free survival (RFS) and overall survival (OS), and investigated the role of adjuvant chemotherapy in patients with small bowel adenocarcinoma (SBA). Methods: Data from 52 patients with SBA who underwent curative surgery at the Asan Medical Center between January 1989 and December 2009 were retrospectively analyzed. Patients were divided into two groups: those who did (n = 23) and did not (n = 29) receive adjuvant chemotherapy. Results: At a median follow-up of 32.2 months (range, 5.5-212.2 months), relapses had occurred in 17 patients (32.7%), with a 5-year RFS rate of 52.9% (95% CI, 39.3-66.5%), and 19 patients (36.5%) had died, with a 5-year OS rate of 59.0% (95% CI, 45.6-72.4%). The most frequent sites of relapse were the peritoneum and liver. Multivariate analysis showed that lymph node involvement was the only factor independently associated with poor RFS and OS. After inverse probability of treatment weighting adjustment, adjuvant chemotherapy did not enhance RFS [hazard ratio (HR), 1.399; 95% CI, 0.498-3.933] or OS (HR 0.797; 95% CI, 0.307-2.068). Conclusions: Lymph node involvement is a predictor of poor prognosis in patients with SBA who undergo curative surgery. Copyright (C) 2011 S. Karger AG, Basel