Efficacy of Postoperative Adjuvant Chemotherapy According to Prognostic Factor in Patients with Stage III Colon Cancer
Efficacy of Postoperative Adjuvant Chemotherapy According to Prognostic Factor in Patients with Stage III Colon Cancer
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DOI：
10.4236/jct.2014.58088
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发表时间：
2014-07
期刊：
影响因子：
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通讯作者：
K. Sugimoto;K. Sakamoto;Y. Tomiki;M. Goto;Y. Kojima;H. Komiyama;Makoto Takahashi;S. Ishiyama;K. Niwa;Haruna Okubo
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文献类型：
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作者：
K. Sugimoto;K. Sakamoto;Y. Tomiki;M. Goto;Y. Kojima;H. Komiyama;Makoto Takahashi;S. Ishiyama;K. Niwa;Haruna Okubo
背景：我们回顾确定了III期结肠癌患者的预后因素，并根据这些预后因素考虑了术后辅助化疗的有效性。方法：234例结肠癌根治性手术治疗的淋巴结转移患者纳入本研究。首先，对临床病理因素和生存数据进行分析，以确定与癌症特异性生存相关的预后因素。其次，基于这些预后因素，我们检查了术后辅助化疗的有效性。结果：多因素分析显示分化程度(P=0.03，危险比=2.50)、淋巴侵犯(P=0.02，危险比=3.23)和TNM分类第7版(P=0.04，危险比=1.94)是影响预后的独立因素。在被归类为TNM IIIA的患者中，无复发生存率非常好。在IIIB和IIIC患者中，接受术后辅助化疗的患者与未接受辅助化疗的患者相比，差异无统计学意义。结论：本研究提示，IIIA期结肠癌患者可能不需要术后辅助化疗。对于预后较差的IIIB期和IIIC期结肠癌患者，应考虑奥沙利铂联合5-FU治疗。
Background: We retrospectively identified prognostic factors in patients with Stage III colon cancer and considered the effectiveness of postoperative adjuvant chemotherapy based on these prognostic factors. Methods: Two hundred and thirty four patients with lymph node metastases who underwent curative surgery for colon cancer between 1999 and 2005 were enrolled in the present study. Firstly, clinicopathological factors and survival data, were analyzed to determine prognostic factors related to cancer-specific survival. Secondly, we examined the effectiveness of postoperative adjuvant chemotherapy based upon these prognostic factors. Results: The multivariate analysis revealed that differentiation (P = 0.03, Hazard ratio = 2.50), lymphatic invasion (P = 0.02, Hazard ratio = 3.23) and the TNM classification, 7th edition (P = 0.04, Hazard ratio = 1.94) were found to be significant independent prognostic factors. Among the patients classified as TNM IIIA, the recurrence-free survival rates were extremely good. Among the patients classified as IIIB and IIIC, there was no significant difference between the patients with and without postoperative adjuvant chemotherapy. Conclusion: The present study suggests that the patients with Stage IIIA colon cancer may not require postoperative adjuvant chemotherapy. The addition of oxaliplatin to 5-FU should be considered for the patients with Stage IIIB and IIIC colon cancer, for whom the prognoses are far from satisfactory.