Prognostic impact of lymph node dissection is different for male and female colon cancer patients: a propensity score analysis in a multicenter retrospective study
Prognostic impact of lymph node dissection is different for male and female colon cancer patients: a propensity score analysis in a multicenter retrospective study
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DOI：
10.1007/s00384-016-2558-x
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发表时间：
2016-03
影响因子：
2.8
通讯作者：
S. Ishihara;K. Otani;K. Yasuda;T. Nishikawa;Toshiaki Tanaka;J. Tanaka;T. Kiyomatsu;K. Kawai;K. Hata;H. Nozawa;S. Kazama;H. Yamaguchi;E. Sunami;J. Kitayama;K. Sugihara;Toshiaki Watanabe
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文献类型：
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作者：
S. Ishihara;K. Otani;K. Yasuda;T. Nishikawa;Toshiaki Tanaka;J. Tanaka;T. Kiyomatsu;K. Kawai;K. Hata;H. Nozawa;S. Kazama;H. Yamaguchi;E. Sunami;J. Kitayama;K. Sugihara;Toshiaki Watanabe
目的探讨男性和女性结肠癌在肿瘤学上的差异。本研究的目的是阐明淋巴结清扫术（LND）在男性和女性结肠癌patients.MethodsA的预后影响，共5941期I-III结肠癌患者谁是治愈性手术期间，1997年至2007年进行了回顾性研究。分别比较了接受D3、D2和D1 LND治疗的男性和女性患者的癌症特异性生存期（CSS）。结果D3、D2和D1 LND分别为3756例（63%）、1707例（29%）和478例（8%），年龄越小和疾病越严重，LND范围越广。在男性患者中，与D1 LND相比，D2 LND与癌症特异性死亡率降低显着相关（HR 0.54，95%CI 0.32- 0.89，p = 0.04），但在女性患者中则不然。D3 LND与D2 LND相比，男性和女性患者的预后均无明显改善。结论与D1 LND相比，D2 LND可改善男性结肠癌患者的CSS，但与女性无关。这表明男性和女性患者的结肠癌可能在肿瘤学上不同，因此，结肠癌手术干预程度的预后影响可能在性别之间存在差异。
PurposeColon cancers in male and female patients are suggested to be oncologically different. The aim of this study is to elucidate the prognostic impact of lymph node dissection (LND) in male and female colon cancer patients.MethodsA total of 5941 stage I-III colon cancer patients who were curatively operated on during the period from 1997 to 2007 were retrospectively studied. Cancer-specific survival (CSS) was individually compared between for male and female patients treated with D3, D2, and D1 LND. Background differences of the patients were matched using propensity scores.ResultsD3, D2, and D1 LND were performed in 3756 (63 %), 1707 (29 %), and 478 (8 %), respectively, and more extensive LND was indicated for younger patients and more advanced disease. D2 LND was significantly associated with decreased cancer-specific mortality compared to D1 LND in male patients (HR 0.54, 95 % CI 0.32–0.89,p= 0.04), but not in female patients. D3 LND did not correlate to an improved prognosis compared to D2 LND both in male and female patients.ConclusionsD2 LND was associated with an improved CSS in male, but not female colon cancer patients, compared to D1 LND. This suggested that colon cancer in male and female patients might be oncologically different, and that the prognostic impact of the extent of surgical intervention for colon cancer might therefore be different between sexes.