Incidence, predictors and prognostic implications of positive circumferential resection margin in colon cancer: A retrospective study in a Chinese high-volume cancer center.
Incidence, predictors and prognostic implications of positive circumferential resection margin in colon cancer: A retrospective study in a Chinese high-volume cancer center.
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DOI：
10.3389/fonc.2022.871570
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发表时间：
2022
影响因子：
4.7
通讯作者：
Li, Xinxiang
中科院分区：
文献类型：
--
作者：
Luo, Dakui;Li, Jing;He, Weijing;Yang, Yufei;Cai, Sanjun;Li, Qingguo;Li, Xinxiang
直肠癌切缘阳性与复发率高、生存率低有关。直肠癌CRM的预测因素已被广泛研究。我们的研究旨在确定中国高容量癌症中心结肠癌（CC）手术后阳性CRM的发生率、预测因素和预后意义。从复旦大学附属肿瘤医院数据库中识别2008年1月至2018年12月期间接受手术的CC患者的临床病理特征和肿瘤学结局。CRM阳性定义为切缘≤1 mm。在我们的研究中，共确定了5268例I-IV期CC患者，其中108例（2.05%）CRM阳性。多因素Logistic回归分析发现，晚期N分期、远处转移和低分化肿瘤患者CRM阳性的风险增加。经倾向评分匹配后，CRM阳性和阴性患者的5年总生存率分别为33.2%和39.8%（P=0.005）。多因素考克斯回归模型显示CRM阳性是CC患者OS的独立预后因素。本中心CRM阳性率总体低于西方人群。几个不良的病理参数值得更多的关注，以确定CC患者的积极CRM的高风险。采用适当的手术技术和多学科治疗计划，预计将改善高选择性CC患者的肿瘤结局与“高风险”CRM参与。
Positive circumferential resection margin (CRM) was associated with a higher recurrence rate and worse survival in rectal cancer. Predictors of CRM in rectal cancer have widely been investigated. Our study aims to determine the incidence, predictors and prognostic implications of positive CRM following colon cancer (CC) surgery in a Chinese high-volume cancer center. The clinicopathological features and oncological outcomes of CC patients undergoing surgery between January 2008 and December 2018 were identified from Fudan University Shanghai Cancer Center database. Positive CRM was defined as resection margin ≤1 mm. A total of 5268 stage I-IV CC patients were identified in our study, 108 (2.05%) of whom had positive CRM. Multivariate logistic analysis found that advanced N stage, distant metastases and poorly differentiated tumor had increased risk of positive CRM. After propensity score matching, the 5-year overall survival rates of the patients with positive and negative CRM were 33.2% and 39.8% (P=0.005), respectively. Multivariable COX regression model showed that positive CRM was an independent prognostic factor for OS in CC patients. The overall rate of positive CRM in our center is lower than that in western population. Several adverse pathological parameters deserve more attention to identify CC patients at a high risk of positive CRM. Adoption of appropriate surgical techniques and multidisciplinary treatment planning are expected to improve oncological outcomes for high selected CC patients with “high-risk” CRM involvement.
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影响因子：
168.9
作者：
Quirke, Phil;Steele, Robert;Monson, John;Grieve, Robert;Khanna, Subhash;Couture, Jean;O'Callaghan, Chris;Myint, Arthur Sun;Bessell, Eric;Thompson, Lindsay C.;Parmar, Mahesh;Stephens, Richard J.;Sebag-Montefiore, David
通讯作者：
Sebag-Montefiore, David
影响因子：
168.9
作者：
ADAM, IJ;MOHAMDEE, MO;QUIRKE, P
通讯作者：
QUIRKE, P
影响因子：
4
作者：
Liu Q;Luo D;Cai S;Li Q;Li X
通讯作者：
Li X
影响因子：
2.5
作者：
Goffredo, Paolo;Zhou, Peige;Hassan, Imran
通讯作者：
Hassan, Imran
影响因子：
9
作者：
Roodbeen, Sapho X.;de lacy, F. B.;Hompes, Roel
通讯作者：
Hompes, Roel