The clinical significance of distal spread differs according to the primary tumor location in rectal cancer
The clinical significance of distal spread differs according to the primary tumor location in rectal cancer
复制标题
直肠癌远端扩散的临床意义根据原发肿瘤位置的不同而不同
DOI：
10.1007/s00595-019-01882-x
复制
发表时间：
2019
期刊：
影响因子：
2.5
通讯作者：
T. Wakai
中科院分区：
文献类型：
--
作者：
K. Abe;Y. Shimada;H. Oyanagi;R. Yagi;M. Nakano;H. Kameyama;Hitoshi Nogami;S. Maruyama;Y. Takii;T. Wakai
目的直肠癌位于腹膜反折上方（RS/Ra）和下方（Rb）的治疗策略不同。根据远端扩散（DS）的程度，日本结肠直肠癌协会提出了RS/Ra和Rb肿瘤的最佳远端切缘。本研究旨在探讨RS/Ra和Rb肿瘤DS的临床意义。方法回顾性分析287例未经术前治疗的I-III期直肠癌根治性切除患者的临床资料。DS和其他病理因素进行了评估，使用整体安装切片。为了研究DS在RS/Ra和Rb肿瘤中的临床意义，根据肿瘤组分析了包括DS在内的临床病理变量的生存结局。结果185例RS/Ra肿瘤中20例（11%）有DS，102例Rb肿瘤中8例（8%）有DS。DS与RS/Ra肿瘤的总生存期（OS）或无复发生存期（RFS）无显著相关性，但却是Rb肿瘤OS和RFS的独立预后因素（分别为P = 0.002和0.007）。结论RS/Ra和Rb肿瘤DS的临床意义不同。DS与Rb肿瘤的生存率较差相关，但与RS/Ra肿瘤无关。
Purpose Treatment strategies of rectal cancer differ between tumors located above (RS/Ra) and below (Rb) the peritoneal reflection. Based on the extent of distal spread (DS), the Japanese Society for Cancer of Colon and Rectum proposed an optimal distal margin in RS/Ra and Rb tumors. In this study, we investigated the clinical significance of DS between RS/Ra and Rb tumors. Methods We analyzed 287 stage I–III rectal cancer patients who underwent curative intent resection without preoperative therapy. DS and other pathological factors were evaluated using whole-mount sections. To investigate the clinical significance of DS in RS/Ra and Rb tumors, clinicopathological variables, including DS, were analyzed for the survival outcome according to the tumor group. Results DS was detected in 20 out of 185 (11%) patients with RS/Ra tumors and 8 out of 102 (8%) patients with Rb tumors. DS was not significantly associated with the overall survival (OS) or relapse-free survival (RFS) in RS/Ra tumors, but was an independent prognostic factor for the OS and RFS in Rb tumors ( P = 0.002 and 0.007, respectively). Conclusions The clinical significance of DS differs between RS/Ra and Rb tumors. DS is associated with a worse survival in Rb tumors, but not in RS/Ra tumors.
影响因子：
9.6
作者：
HEALD, RJ;HUSBAND, EM;RYALL, RDH
通讯作者：
RYALL, RDH