Prognostic significance of doubling time in patients undergoing radical surgery for metachronous peritoneal metastases of colorectal cancer
Prognostic significance of doubling time in patients undergoing radical surgery for metachronous peritoneal metastases of colorectal cancer
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倍增时间对结直肠癌异时性腹膜转移根治术患者的预后意义
DOI：
10.1007/s00384-019-03259-5
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发表时间：
2019
影响因子：
2.8
通讯作者：
Ishihara Soichiro
中科院分区：
文献类型：
--
作者：
Miyake Hiroaki;Murono Koji;Nagata Hiroshi;Nozawa Hiroaki;Kawai Kazushige;Hata Keisuke;Tanaka Toshiaki;Nishikawa Takeshi;Shuno Yasutaka;Sasaki Kazuhito;Ishihara Soichiro
目的探讨肿瘤体积倍增时间和肿瘤标志物与结直肠癌肝、肺转移预后的关系。然而，没有研究评估腹膜转移。因此，我们的目的是阐明倍增时间和预后的患者进行根治性手术的异时性腹膜转移的CRC.MethodsWe计算肿瘤倍增时间（TDT）腹膜转移和血清癌胚抗原倍增时间（CEA DT）在33例连续患者谁接受根治性手术异时性腹膜转移2006年1月至2017年4月。结果长TDT（> 137天）组5年OS率为74.1%，中位OS时间为6.6年。在长CEA-DT（> 102天）组中，5年OS率为50.0%，中位OS时间为5.6年。相反，在短TDT（≤ 137天）和CEA-DT（≤ 102天）组中，5年OS率和中位OS时间分别为0.0%和3.2年。在多变量分析中，短TDT是RFS（P= 0.006）和OS（P= 0.010）差的独立风险因素。结论短TDT和CEA-DT是结直肠癌异时性腹膜转移患者术后OS和RFS差的独立危险因素。在选择手术切除的候选人时，应考虑TDT和CEA-DT。
PurposeThe doubling times of tumor volume and tumor markers are associated with the prognosis of liver or lung metastases from colorectal cancer (CRC). However, no studies have assessed peritoneal metastases. Therefore, we aimed to elucidate the association between doubling time and the prognosis of patients who underwent radical surgery for metachronous peritoneal metastases of CRC.MethodsWe calculated the tumor doubling times (TDT) of peritoneal metastases and serum carcinoembryonic antigen-doubling times (CEA-DT) in 33 consecutive patients who underwent radical surgery for metachronous peritoneal metastases between January 2006 and April 2017. The impact of short TDT and CEA-DT on overall survival (OS) and relapse-free survival (RFS) was retrospectively reviewed.ResultsIn long TDT (> 137 days) group, the 5-year OS rate was 74.1% and median OS time was 6.6 years. In long CEA-DT (> 102 days) group, the 5-year OS rate was 50.0% and median OS time was 5.6 years. Conversely, in short TDT (≤ 137 days) and CEA-DT (≤ 102 days) group, the 5-year OS rates and median OS times were both 0.0% and 3.2 years, respectively. In the multivariate analysis, short TDT was an independent risk factor for poor RFS (P= 0.006) and OS (P= 0.010). Similarly, short CEA-DT was also a poor risk factor for RFS (P< 0.001) and OS (P= 0.012).ConclusionsShort TDT and CEA-DT are independent risk factors for poor OS and RFS after surgery for metachronous peritoneal metastases of CRC. TDT and CEA-DT should be considered when selecting candidates for surgical resection.