Hazard function analysis of metastatic recurrence after colorectal cancer surgery-A nationwide retrospective study
Hazard function analysis of metastatic recurrence after colorectal cancer surgery-A nationwide retrospective study
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DOI：
10.1002/jso.26378
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发表时间：
2021-01-14
影响因子：
2.5
通讯作者：
Ishihara, Soichiro
中科院分区：
文献类型：
--
作者：
Ishimaru, Kazuhiro;Kawai, Kazushige;Ishihara, Soichiro
背景与目的结肠直肠癌（CRC）的最佳术后监测方案取决于对复发时间线的了解。通过危害函数分析，评价肿瘤发生转移的时间。方法回顾性收集日本研究组I-III期结肠癌患者21671例，进行结直肠癌术后随访。结果5年脏器转移发生率分别为：肝脏6.3%（右：左= 5.5%:7.0%,p = 0.0067），肺6.0%（右：左：直肠= 3.7%:4.4%:8.8%,p = 7.05E-45），腹膜2.0%（右：左：直肠= 3.1%:2.0%:1.2%,p = 1.29E-12）。肝转移危险率（HR）峰值（0.67年）较其他转移灶更早且更高。早期crc的峰值HR倾向于延迟（I、II和III期分别为0.91、0.76和0.52年）。根据原发肿瘤部位（右侧、左侧和直肠）进行分析时，肺癌转移的HR峰值是结肠癌的两倍，右侧结肠癌腹膜转移的HR较高。结论基于原发肿瘤部位的各种转移器官复发风险的时间过程在本研究中清晰可见。这将有助于个性化术后监测时间表。
Background and Objectives An optimal postoperative surveillance protocol for colorectal cancer (CRC) is dependent on understanding the time line of recurrence. By hazard function analysis, this study aimed at evaluating the time of occurrence of metastasis.Methods A total of 21,671 Stage I-III colon cancer patients were retrospectively included from the Japanese study group for postoperative follow-up of colorectal cancer database.Results The 5-year incidence by metastasized organ was 6.3% for liver (right:left = 5.5%:7.0%, p = .0067), 6.0% for lung (right:left:rectum = 3.7%:4.4%:8.8%, p = 7.05E-45), and 2.0% for peritoneal (right:left:rectum = 3.1%:2.0%:1.2%, p = 1.29E-12). The peak of liver metastasis hazard rate (HR) (0.67 years) was earlier and higher than those of other metastases. The peak HR tended to be delayed in early stage CRCs (0.91, 0.76, and 0.52 years; for Stages I, II, and III, respectively). When analyzed as per the primary tumor location (right-sided, left-sided, and rectum), the peak HR for lung metastasis was twice as high for rectal cancer than for colon cancer, and peritoneal metastasis had a high HR in right-sided colon cancers.Conclusion The time course for the risk of recurrence in various metastatic organs based on the primary tumor site was clearly visualized in this study. This will aid in individualizing postoperative surveillance schedules.