Mucinous histology predicts for reduced fluorouracil responsiveness and survival in advanced colorectal cancer
Mucinous histology predicts for reduced fluorouracil responsiveness and survival in advanced colorectal cancer
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DOI：
10.1093/annonc/mdi244
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发表时间：
2005-08-01
影响因子：
50.5
通讯作者：
Ross, PJ
中科院分区：
文献类型：
--
作者：
Negri, FV;Wotherspoon, A;Ross, PJ
背景：结肠和直肠粘液癌（粘液性 CRC）是结直肠腺癌的一种组织学亚型，其化疗反应性的数据很少。本研究的目的是专门调查以氟尿嘧啶为基础的一线化疗对晚期粘液性 CRC 患者的疗效。 患者和方法：将所有参加三项评估输注 5-氟尿嘧啶作为一线治疗的前瞻性随机试验的晚期粘液性 CRC 患者与参加病例对照研究中相同试验的非粘液性 CRC 患者进行比较。使用单变量和多变量 Logistic 和/或 Cox 比例风险分析确定与总体缓解率 (ORR)、无进展生存期 (PFS) 和总体生存期 (OS) 相关的预后因素。 结果：该研究包括 135 名患者（45 名病例和 90 名对照）。病例和对照的缓解率分别为 22% [95% 置信区间 (CI)，11% 至 38%] 和 47%（95% CI，36. 1 % 至 58.2%）（P=0.0058）。粘液性 CRC 患者的中位 OS 为 11.8 个月 (95% Cl 8.87-14.8)，而对照组为 17.9 个月 (95% Cl, 13.38-22.39)（单变量分析，P=0.056）；通过多变量 Cox 回归分析校正显着预后因素后，P = 0.0372，风险比 (HR) = 1.497 (1.02-2.19)。结论：与非粘液性 CRC 患者相比，晚期粘液性 CRC 患者对基于氟尿嘧啶的一线化疗的反应较差，生存率较低。
Background: Mucinous carcinoma of the colon and rectum (mucinous CRC) is a histological subtype of colorectal adenocarcinoma for which there is little data on chemotherapy responsiveness. The purpose of this study was to investigate specifically the efficacy of fluorouracil -based first-line chemotherapy in patients with advanced mucinous CRC.Patients and methods: All patients with advanced mucinous CRC enrolled in three prospective randomized trials evaluating infused 5-fluorouracil as first-line treatment were compared with patients with non-mucinous subtypes enrolled in the same trials in a case-control study. Prognostic factors associated with overall response rate (ORR), progression -free survival (PFS) and overall survival (OS) were identified using univariate and multivariate logistic and/or Cox proportional hazards analyses.Results: The study included 135 patients (45 cases and 90 controls). The response rates for cases and controls were 22% [95% confidence interval (CI), 11% to 38%] and 47% (95% Cl, 36. 1 % to 58.2%), respectively (P=0.0058). Median OS for the mucinous CRC patients was 11.8 months (95% Cl 8.87-14.8) compared with 17.9 months (95% Cl, 13.38-22.39) in the control group (Univariate analysis, P=0.056); after correcting for significant prognostic factors by multivariate Cox regression analysis, P = 0.0372 and hazard ratio (HR) = 1.497 (1.02-2.19).Conclusion: Patients with advanced mucinous CRC have a poorer response to fluorouracil -based first-line chemotherapy and reduced survival compared with patients with non-mucinous CRC.