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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2021, Vol. 30 Issue (1): 47-53    DOI: 10.3760/cma.j.cn113030-20190821-00338
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肿瘤沉积对ypⅢ期直肠癌患者预后的预测价值
朱巧萍, 李安川, 徐本华
福建医科大学附属协和医院放疗科,福州 350001
Predictive value of tumor deposit for the prognosis of patients with yp-stage Ⅲ rectal cancer
Zhu Qiaoping, Li Anchuan, Xu Benhua
Department of Radiation Oncology, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, China
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摘要 目的 分析肿瘤沉积(TD)的存在对ypⅢ期直肠癌患者预后的预测作用及其对术后辅助化疗获益的影响。方法 回顾分析2007—2017年间福建医科大学附属协和医院接受多学科综合治疗的338例ypⅢ期直肠癌患者资料,将其分为TD(-)组(301例)和TD(+)组(37例)。Kaplan-Meier法并log-rank检验差异和单因素预后分析,Cox模型多因素分析。结果 TD(-)组5年总生存、无远处转移生存、无进展生存均高于TD(+)组(59.3%∶42.0%,P=0.001;79.1%∶55.0%,P<0.001;55.6%∶38.0%,P<0.001),但局部无复发生存相近(96.7%∶85.5%,P=0.679)。单因素预后分析显示TD(+)组中TD个数与患者预后无关(P=0.923),术后辅助化疗对两组患者预后均无影响(P=0.103)。多因素预后分析显示TD与更差的总生存相关(HR=2.343,95%CI为1.257~4.363,P=0.007)。结论 对于接受多学科综合治疗的ypⅢ期直肠癌患者,TD(+)者的预后更差,TD是总生存的独立预测因子;无论患者是否存在TD,均未能从术后辅助化疗中获益。
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朱巧萍
李安川
徐本华
关键词 肿瘤沉积直肠肿瘤/综合疗法预后    
AbstractObjective To analyze the predictive effect of tumor deposit(TD) on the prognosis of yp-stage Ⅲ rectal cancer patients,and its effect on postoperative adjuvant chemotherapy benefit. Methods Clinical data of 338 ypⅢ stage rectal cancer patients who received multidisciplinary treatment in Union Medical College Affiliated Hospital of Fujian Medical University from 2007 to 2017 were retrospectively analyzed. All patients were divided into the TD(-) group(n=301) and TD(+) group(n=37). Survival analysis was conducted by Kaplan-Meier method, log-rank test and univariate prognostic analysis. Multivariate prognostic analysis was performed by Cox’s regression model. Results The 5-year overall survival(OS), progress-free survival(PFS), and distant metastasis-free survival(DMFS) in the TD(-) group were significantly higher than those in the TD(+) group(59.3% vs. 42.0%,P=0.001, 79.1% vs. 55.0%,P<0.001, 55.6% vs. 38.0%,P<0.001),whereas no significant difference was observed in local recurrence-free survival(LRFS) between two groups(96.7% vs. 85.5%,P=0.679). Univariate prognostic analysis revealed that the number of TD was not correlated with the prognosis of patients(P=0.923), and postoperative adjuvant chemotherapy exerted no significant effect on the prognosis of patients in two groups(P=0.103). In multivariate analysis, TD was associated with worse OS(HR=2.343,95%CI:1.257-4.363, P=0.007). Conclusions For patients with ypⅢ stage rectal cancer undergoing multidisciplinary treatment, the prognosis of patients with TD is even worse. TD is an independent predictor for survival. No benefit can be obtained from postoperative adjuvant chemotherapy regardless of the presence or absence of TD.
Key wordsTumor deposit    rectal neoplasm/multidisciplinary treatment    Prognosis   
收稿日期: 2019-08-21     
基金资助:福建医科大学启航基金研究生创新项目(2017XQ2034)
通讯作者: 徐本华,Email:benhuaxu@ 163.com;李安川,Email:lianchuan@outlook.com   
引用本文:   
朱巧萍,李安川,徐本华. 肿瘤沉积对ypⅢ期直肠癌患者预后的预测价值[J]. 中华放射肿瘤学杂志, 2021, 30(1): 47-53.
Zhu Qiaoping,Li Anchuan,Xu Benhua. Predictive value of tumor deposit for the prognosis of patients with yp-stage Ⅲ rectal cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(1): 47-53.
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