Tumor Deposit Is a Poor Prognostic Indicator for Patients Who Have Stage II and III Colorectal Cancer With Fewer Than 4 Lymph Node Metastases but not for Those With 4 or More
Tumor Deposit Is a Poor Prognostic Indicator for Patients Who Have Stage II and III Colorectal Cancer With Fewer Than 4 Lymph Node Metastases but not for Those With 4 or More
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DOI：
10.1097/dcr.0000000000000059
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发表时间：
2014-04-01
影响因子：
3.9
通讯作者：
Tanaka, Masao
中科院分区：
文献类型：
--
作者：
Nagayoshi, Kinuko;Ueki, Takashi;Tanaka, Masao
背景：结外肿瘤沉积涉及TNM分期。然而，肿瘤存款是否是一种规则的淋巴结转移尚不确定，其在II期或III期结直肠癌患者中的预后意义仍有待确定。目的：本研究旨在确定肿瘤沉积对II期和III期结直肠癌的预后意义。设计：本研究是对临床病理资料的回顾性分析。本研究在日本的一家三级医院/转诊中心进行。患者：我们回顾了1999年1月至2006年12月期间171例II期和173例III期连续患者的临床过程。我们研究了结直肠癌伴肿瘤沉积的临床病理特征，并根据肿瘤沉积的状态计算患者的总生存期和无复发生存期。主要结局是肿瘤沉积对患者生存率的影响。结果：35例（10.2%）结直肠癌患者在结肠周围和/或结肠系膜区域有肿瘤沉积。有肿瘤沉积的患者的生存率显著低于无肿瘤沉积的患者（5年总生存率：58.4% vs 81.0%，p < 0.0001; 5年无复发生存率：47.1% vs 73.4%，p < 0.0001）。在多变量分析中，肿瘤存款是结直肠癌患者的独立预后因素（总生存期：HR，2.30; 95% CI，1.26-4.04; p = 0.04;无复发生存期：HR，2.42; 95% CI，1.04-4.90; p = 0.04）。肿瘤存款是一个独立的预后因素，在N 0和N1结直肠癌，而N2癌有不良的生存结局，无论肿瘤存款.LIMITATIONS：我们的研究是一个单机构的回顾性研究，患者人数相对较少，得出坚定的结论.CONCLUSION：肿瘤存款可能是一个独立的不良预后因素，为II期和III期N1结直肠癌。
BACKGROUND: Extranodal tumor deposits are involved in TNM classification. However, it is uncertain whether a tumor deposit is a regular lymph node metastasis, and its prognostic significance in patients with stage II or III colorectal cancer remains to be established.OBJECTIVE: This study aimed to determine the prognostic significance of tumor deposits for stage II and III colorectal cancer.DESIGN: This study is a retrospective review of clinicopathological data.SETTING: This study was conducted at a tertiary care hospital/referral center in Japan.PATIENTS: We reviewed the clinical course of 171 stage II and 173 stage III consecutive patients between January 1999 and December 2006.MAIN OUTCOME MEASURES: We examined the clinicopathological features of colorectal cancers with tumor deposits and calculated overall survival and recurrence-free survival of the patients according to the status of tumor deposits. The primary outcome was the impact of tumor deposits on patient survival.RESULTS: Thirty-five (10.2%) patients with colorectal cancers had tumor deposits in the pericolic and/or mesocolic region. Survival rates among the patients with tumor deposits were significantly lower than those without (5-year overall survival: 58.4% vs 81.0%, p < 0.0001; 5-year recurrence-free survival: 47.1% vs 73.4%, p < 0.0001). Tumor deposit was an independent prognostic factor for patients with colorectal cancer in multivariate analysis (overall survival: HR, 2.30; 95% CI, 1.26-4.04; p = 0.04; recurrence-free survival: HR, 2.42; 95% CI, 1.04-4.90; p = 0.04). Tumor deposit was an independent prognostic factor in N0 and N1 colorectal cancer, whereas N2 cancer had poor survival outcome regardless of tumor deposit.LIMITATIONS: Our study was a single-institution retrospective study, and the numbers of patients were relatively small to draw firm conclusions.CONCLUSION: Tumor deposit may be an independent adverse prognostic factor for stage II and III N1 colorectal cancer.