Effect of tumor deposits on overall survival in colorectal cancer patients with regional lymph node metastases.
Effect of tumor deposits on overall survival in colorectal cancer patients with regional lymph node metastases.
复制标题
肿瘤沉积物对有区域淋巴结转移的大肠癌患者总生存率的影响。
DOI：
10.2185/jrm.2880
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Okamoto H
中科院分区：
文献类型：
--
作者：
Yabata E;Udagawa M;Okamoto H
目的：国际抗癌联合会的分期系统认为无区域淋巴结转移的患者肿瘤沉积为N1 c，但区域淋巴结转移患者肿瘤沉积的意义尚不清楚。我们研究了肿瘤沉积物对结直肠癌区域淋巴结转移患者总生存率的影响。患者和方法：从2000年到2008年，551例患者在我们的医疗中心接受了结直肠癌切除术。我们从我们的研究中排除了87例有远处转移或接受过新辅助化疗或放疗的患者，并对其余464例患者进行了统计学分析。结果如下：区域淋巴结转移患者的逐步多变量考克斯比例风险分析显示，只有肿瘤沉积对总生存率有显著影响（风险比：2.813; P = 0.0002）。有肿瘤沉积的患者复发率为49.2%（30/61），而无肿瘤沉积的患者复发率为14.4%（58/403; P < 0.0001）。肿瘤沉积物对总生存率的影响与淋巴结转移不同。结论：在结直肠癌伴区域淋巴结转移患者中，肿瘤沉积与总生存率降低显著相关。肿瘤沉积对总生存率的影响介于淋巴结转移和远处转移之间。
Objectives: The staging system of the International Union Against Cancer considers tumor deposits to be N1c in patients with no regional lymph node metastasis, but the significance of tumor deposits in patients with regional lymph node metastases is unclear. We investigated the effect of tumor deposits on overall survival in colorectal cancer patients with regional lymph node metastases. Patients and Methods: From 2000 to 2008, 551 patients underwent resections for colorectal cancer at our medical center. We excluded 87 patients who had distant metastases or had received neoadjuvant chemotherapy or radiotherapy from our study and statistically analyzed the remaining 464 patients. Results: Stepwise multivariate Cox proportional hazards analysis in patients with regional lymph node metastases showed only tumor deposits to be significant for overall survival (hazard ratio: 2.813; P = 0.0002). Recurrence was seen in 49.2% of patients with tumor deposits (30/61) compared with 14.4% of patients without them (58/403; P < 0.0001). Tumor deposits did not show the same effect on overall survival as lymph node metastases. Conclusions: Tumor deposits were significantly associated with poorer overall survival in colorectal cancer patients with regional lymph node metastases. The effect of tumor deposits on overall survival was between that of lymph node metastasis and distant metastasis.