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題名 | Prognosis of Stage IIIA Colorectal Cancer Patients with or without Postoperative Adjuvant Chemotherapy=第IIIA期之大腸直腸癌患者預後分析--術後治療是否是有意義的? |
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作者 | 林耕平; 洪欣園; 王正儀; 張簡俊榮; 唐瑞平; 游耀東; 江支銘; 葉建裕; 謝寶秀; 蔡文司; 游正府; 蔣昇甫; 賴正洲; 陳進勛; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 24:3 2013.09[民102.09] |
頁次 | 頁93-102 |
分類號 | 416.245 |
關鍵詞 | 輔助性治療; 結腸與直腸; 腺癌; Adjurant therapy; Colon & rectum adenocarcinoma; |
語文 | 英文(English) |
中文摘要 | 目的:在美國癌症協會第七版(AJCC7)的分期中,第IIIA期的患者預後比部分第II期的患者為佳。本研究回顧林口長庚紀念醫院過去治療結腸直腸第IIIA期患者之經驗,並討論化學治療對此類患者的意義。方法:本研究回顧並收集林口長庚紀念醫院之結直腸癌及病理學資料庫於1995至2006年間,經診斷罹患結直腸癌之患者中,病理診斷結果為第IIIA期結直腸共149例。另回顧分析上述病患之個別醫療紀錄,並就其臨床病理及人口統計學特徵,病理分類、腫瘤位置、腫瘤期別、治療(手術方式、化學治療或放射線治療)成效、轉移情形,以及存活率等進行分析。結果:T1的患者共31名,其中僅一名在術後發現復發的現象,不論是否有做其他術後輔助性治療,對於預後並無顯著的意義;而在T2的患者中,依照淋巴結轉移的數目(病理檢查N1a與N1b),N1b的患者復發率較N1a為高。另外,即使尚未達到統計學上的顯著差異,未做化學治療的、較差的病理分類、淋巴結檢查數目充分,復發率仍有降低的現象。而在新版分期中歸類為IIIA期的T1N2aM0患者,僅有五名患者均未發生腫瘤復發的現象,與新版分期是相符合的。結論:對第IIIA期中T2的患者,仍然建議要做術後的化學治療。T1期的患者,或許可考慮化學治療的副作用與藥物使用的益處,來決定是否應建議患者接受術後輔助性治療。 |
英文摘要 | Introduction. The new definition of stage IIIA colorectal cancer (CRC) was introduced in the Seventh Edition of the American Joint Committee on Cancer (AJCC 7th). Because the outcomes of patients with stage IIIA CRC are not worse than those of patients with stage II disease, we evaluated whether chemotherapy would also benefit this group of patients.Patients and Methods. Patients who received curative surgery and were diagnosed with stage IIIACRC between 1995 and 2006 were enrolled and analyzed.Results. Total 149 patients diagnosed stage IIIA colorectal cancer were enrolled. In these patients, 31 were T1 stage with only one found recurrence. Whether adjuvant therapy performed or not, there was no significant meaning for their prognosis. For T2 patients, higher recurrence rate was noted with N1b patients. Though no statistical meaning achieved, for those without chemotherapy, mucinous type, insufficient lymph node exam, higher recurrent rate were noted. The new AJCC 7th made difference in T1N2a group. Though only 5 patients collected in this study, none was found tumor recurrence, and the result was compatible with the new staging system.Conclusion. Adjuvant therapy is recommended for stage IIIA CRC patients with T2 disease. However, adjuvant chemotherapy may not be beneficial for stage IIIA CRC patients with T1 disease. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。