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題名 | The Impact of Metastatic Ratio to Retrieved Regional Lymph Nodes on Overall Survival in Patients with Stage III Colorectal Cancer: Focus on Numbers of Lymph Node Retrieved Less than 12=轉移淋巴結比率對第三期大腸直腸癌病人總體存活的影響:針對摘取淋巴結少於12顆者 |
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作者姓名(中文) | 高理鈞; 楊濱輔; 馬政仁; 黃敬文; 陳芳銘; 陳漢文; 黃哲人; 謝建勳; 王照元; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 24:2 2013.06[民102.06] |
頁次 | 頁37-43 |
分類號 | 416.245 |
關鍵詞 | 大腸直腸癌; 第三期; 淋巴結轉移比率; 預後; Colorectal cancer; Stage III; Metastatic lymph node ratio; Prognosis; |
語文 | 英文(English) |
中文摘要 | 目的:在台灣,大腸直腸癌是最常見的癌症死因之一。根據現行的治療準則,淋巴結轉移的數量是該疾病的預後因子。然而,轉移淋巴結佔所有淋巴結的比率跟第三期大腸直腸癌總體存活的關係仍是值得探究的,尤其是針對摘取不到12顆淋巴結病人的探討。方法:2004年一月至2010年12月間,416位第三期大腸直腸癌病人被納入研究。這些病人全都接受手術治療。根據轉移淋巴結比率,我們用四分位法把所有納入研究的患者分成四組(轉移淋巴結比率:小於0.1、0.1 至0.2、0.2 至0.4 及0.4 至1)。另外針對總摘取淋巴結數少於12顆者,再依據轉移淋巴結比率的中位數等分成兩組。然後分析轉移淋巴結比率與總體存活的關係。結果:這些病人年齡的中位數與平均數分為是64歲(介於24至92歲之間)與63.47±13.39歲。總摘取淋巴結數的中位數為13顆(介於1至68顆之間)。不論是否有足夠的淋巴結摘除,第三期大腸直腸癌的存活並無差異。四組不同轉移淋巴結比率的五年總體存活率分別為69.7%、64.5%、62.0% 與37.6%(p值小於0.001)。至於在摘除不足12顆淋巴結的病患之中,較高的轉移淋巴結比率也存在較差的預後。結論:對第三期大腸直腸癌的病人而言,應該考慮把轉移淋巴結比率列為重要的預後因子。尤其是摘取不足12顆淋巴結的病人,較高的轉移淋巴結比率或許比較低者需要更積極的追蹤計畫。 |
英文摘要 | Purpose. Colorectal cancer (CRC) is one of the most common causes of cancer death in Taiwan. According to current treatment guidelines, the number of metastatic lymph nodes is a prognostic factor of the disease. However, the relationship between the ratio of metastatic to examined lymph nodes and overall survival in stage III CRC patients is worth investigation, especially on numbers of retrieved lymph nodes less than 12.Methods. From January 2004 to December 2010, four hundred and sixteen patients with stage III CRC were enrolled. All the patients received surgical intervention. According to the metastatic lymph node ratio (LNR), we divided all the included patients into four groups based on quartiles (LNR: < 0.1, 0.1 to 0.2, 0.2 to 0.4, and 0.4 to 1), and among those patients with 11 or less retrieved lymph nodes, we made two subgroups having a similar patient number depending on median of LNR. Then the correlation between LNR and overall survival was analyzed.Results. The median and mean ages of the studied patients were 64 (range, 24-92) and 63.47±13.39 years, respectively. And the median number of examined lymph nodes was 13 (range, 1-68). The five-year overall survival rates of the four LNR groups were 69.7%, 64.5%, 62.0%, and 37.6%, respectively (p < 0.001), while among patients with less than 12 harvested nodes, the higher LNR subgroup also showed a poorer prognosis.Conclusion. For patients with stage III CRC, LNR might be considered as a crucial prognostic factor. Especially, while the number of retrieved nodes is under 12, high LNR patients might need a more intensive follow-up program compared to those with low LNR. |
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