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題 名 | Adjuvant Chemotherapy for High-risk Stage II Colon Cancer=輔助性化學治療在高風險第二期大腸癌病患之分析 |
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作 者 | 胡勝益; 饒樹文; 陳昭仰; 李家政; 蕭正文; 吳昌杰; 周雨青; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 28:1 2017.03[民106.03] |
頁 次 | 頁1-10 |
分類號 | 416.245 |
關鍵詞 | 輔助性化學治療; 高危險; 第二期大腸癌; Adjuvant chemotherapy; High risk; Stage II colon cancer; |
語 文 | 英文(English) |
中文摘要 | 目的 輔助性化學治療在術後第三期大腸癌病患已是標準治療,但對於高危險第二期大腸癌的病患是否有助益、仍令人存疑;這項研究在評估輔助性化學治療在高危險第二期大腸癌病患的存活效益。方法 從2003 年1 月至2012 年12 月,共371 位接受過治癒性手術的第二期大腸癌病患。先將病患依照有無「高危險因子」分成兩大組,每一大組再依照有無接受「輔助性化學治療」分成兩小組,進而去比較每一個組別之間五年整體存活率的差異性。結果 共計127 位病患無高危險因子,以及244 位病患有任何一項高危險因子。就整體第二期大腸癌病患來說,高危險因子確實會降低五年整體存活率 (78.4% vs. 71.9%, p =0.058),輔助性化學治療可明顯增加第二期大腸癌病患的五年整體存活率 (79.2% vs.63.1%, p < 0.001)。比起無高危險因子的病患,輔助性化學治療對高危險病患而言,提昇五年整體存活率效果尤其顯著 (76.3% vs. 62.9%, p = 0.001; 85.5% vs. 61.5%, p =0.011)!經由統計分析,三個高危險因素被視為能明顯影響第二期大腸癌病患五年整體存活率的獨立預測因子:「術後淋巴結摘取數」、「腸阻塞症狀」和「癌症T 分期」 (HR 1.75,95% CI 1.04-2.95, p = 0.036; HR 3.33, 95% CI 1.60-6.96, p = 0.001; HR 1.94, 95% CI 1.03-3.62, p = 0.039)。結論 輔助性化學治療可明顯增加第二期大腸癌病患的五年整體存活率,高危險的病患尤其效果顯著;此外,「術後淋巴結摘取數」、「腸阻塞症狀」和「癌症T 分期」這三個高危險因素,被視為能顯著影響第二期大腸癌病患五年整體存活率存活率的獨立預測因子。 |
英文摘要 | Purpose. Although adjuvant chemotherapy is the standard treatment for stage III colorectal cancer, it is still controversial in patients with stage II disease. This study aimed to evaluate if adjuvant chemotherapy has any survival benefit for stage II colon cancer patients with poor prognostic factors (high-risk stage II). Methods. A total of 371 patients with stage II colon cancer who underwent curative surgery from January 2003 to December 2012 were enrolled in this study. They were divided into two categories: those with poor prognostic factors and those without. Each category was further divided into two sub-groups according to adjuvant chemotherapy administration. The primary outcome of the analysis was the 5-year overall survival (OS) for patients with poor prognostic factors and chemotherapy administration status. Results. There were 127 patients with no poor prognostic factors and 244 patients with poor prognostic factors. Poor prognostic factors decreased OS in stage II colon cancer (5-year OS: 78.4% vs. 71.9%, p = 0.058), and adjuvant chemotherapy significantly improved the OS (5-year OS: 79.2% vs. 63.1%, p < 0.001). Furthermore, patients with poor prognostic factors benefited more from adjuvant chemotherapy than those without poor prognostic factors (5-year OS: 76.3% vs. 62.9%, p = 0.001; 5-year OS: 85.5% vs. 61.5%, p = 0.011). Three poor prognostic factors had a significant effect on OS in stage II colon cancer. These were the "number of lymph nodes examined, bowel obstruction, and T stage" (hazard ratio 1.75, 95% confidence interval [CI] 1.04-2.95, p = 0.036; HR 3.33, 95% CI 1.60-6.96, p = 0.001; HR1.94, 95% CI 1.03-3.62, p = 0.039, respectively). Conclusions. Adjuvant chemotherapy significantly improves OS in patients with stage II colon cancer, especially in high-risk stage II disease. Three poor prognostic factors were independent predictors of OS in stage II colon cancer: "the number of lymph nodes examined, bowel obstruction, and T stage". |
本系統中英文摘要資訊取自各篇刊載內容。