Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?
Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?
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DOI：
10.1007/s00384-013-1675-z
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发表时间：
2013-08-01
影响因子：
2.8
通讯作者：
Kim, Young Jin
中科院分区：
文献类型：
--
作者：
Huh, Jung Wook;Kim, Chang Hyun;Kim, Young Jin
本研究对1998年12月至2007年12月间连续1,159例非转移性结直肠癌根治性切除患者的早期复发预后进行了评估。1159例患者中280例(24.1%)术后复发，其中96例(34.3%)为术后早期复发(术后<1年)。在多因素分析中，肿瘤位置、肿瘤直径、可回收淋巴结数和淋巴血管侵犯是早期复发的独立预测因素。早期复发组的总生存率显著低于非早期复发组(P<；0.001)和直肠癌(P<；0.001)。III期肿瘤的总生存率在早期和非早期复发患者之间有显著差异(P<；0.001)，而在II期肿瘤患者之间没有差异(P=0.364)。在多变量分析中，早期复发是总体生存不良的独立预测因素。此外，分化程度、N分类和术后化疗是早期和全面复发患者总体生存的独立预测因素。对于接受根治性切除的结直肠癌患者，生存不良与术后早期复发相关。不管复发的间隔有多长，辅助化疗的使用延长了患者的生存时间。
This study evaluated the prognostic value of early recurrence in patients who have undergone curative resection for colorectal cancer.A total of 1,159 consecutive patients who underwent curative resection for non-metastatic colorectal cancer from December 1998 to December 2007 were reviewed. The predictive factors for early recurrence postoperatively and the prognostic factors were analyzed.Of the 1,159 patients, postoperative recurrence was identified in 280 (24.1 %) patients, and 96 (34.3 %) of the 280 patients with recurrence were designed as early recurrence (less than 1 year postoperatively). In multivariate analysis, tumor location, tumor diameter, number of retrieved lymph nodes, and lymphovascular invasion were the independent predictors for early recurrence. The early recurrence group had a significantly lower overall survival rate than that of the non-early recurrence group for both colon cancer (P < 0.001) and rectal cancer (P < 0.001). The overall survival rate for stage III tumors significantly differed between the early and non-early recurred patients (P < 0.001), whereas the rate did not differ between the patients with stage II tumors (P = 0.364). In multivariate analysis, early recurrence was an independent predictor for unfavorable overall survival. Moreover, differentiation, N category, and postoperative chemotherapy were the independent predictors for overall survival for the patients with both early and overall recurrence.Poor survival was associated with early postoperative recurrence for patients who underwent curative resection for colorectal cancer. The use of adjuvant chemotherapy prolonged the survival of patients, irrespective of the interval of recurrence.