| huang. Effect of postoperative adjuvant chemotherapy on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy. Oncol Transl Med, 2023, 9: 43-48. |
| 术后辅助化疗对行新辅助化疗直肠癌ypT0-2N0期患者预后的影响 |
| Effect of postoperative adjuvant chemotherapy on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy |
| Received:September 27, 2021 Revised:May 19, 2022 |
| DOI：10.1007/s10330-021-0525-5 |
| 中文关键词: 直肠癌；术后辅助化疗；新辅助化疗；直肠全系膜切除 |
| 英文关键词: rectal cancer; postoperative adjuvant chemotherapy; neoadjuvant chemoradiotherapy; total mesorectal excision |
| 基金项目:国家自然科学基金(31572512) |
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| 中文摘要: |
| 目的：探讨术后辅助化疗(AC)对接受新辅助化疗直肠癌ypT0-3N0期患者预后的影响。方法：选择110例局部进展期结肠癌患者为研究对象，均接受直肠全系膜切除(TME)和淋巴结清扫，34例患者未接受术后AC治疗(TME组)，76例患者术后接受了术后AC治疗(TME＋AC组)，比较两组患者的5年生存率(OS)及无病生存率(DFS)的差异。结果：(1)年龄是影响患者选择术后治疗的重要决定因素，术后未接受AC治疗的患者明显比接受AC治疗的患者年龄大(P＜0.05)。AC组患者肿瘤部位(肛缘以上距离)明显高于未接受AC组(P＜0.05)。(2)Log-rank检验显示，TME＋AC组患者的5年DFS(2=2.125,P=0.225)及5年OS(2=2.689,P=0.186)与TME组无明显差异，术后AC对直肠癌患者的预后没有显著改善作用。(3)Cox多因素分析结果显示，年龄、肿瘤分化、淋巴结切除数量均是影响患者总体生存率的独立性因素(P＜0.05)，患者年龄越高、肿瘤分化程度越低、淋巴结切除数量＜12枚的患者，预后较差(P＜0.05)。结论：新辅助化疗后下调的ypT0-3N0直肠癌患者，尤其是无不良预后因素的直肠癌患者，术后可不进行AC。 |
| 英文摘要: |
| Objective The aim of this study was to investigate the effect of adjuvant chemotherapy (AC) on the
prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy.
Methods The study participants were 110 patients with locally advanced rectal cancer. Thirty-four
patients did not receive postoperative AC treatment, and the other 76 patients received postoperative AC
treatment. The differences in the 5-year overall survival (OS) and disease-free survival (DFS) between the
two groups were compared.
Results Age was an important determinant of the patients’ decision to undergo postoperative treatment.
Patients who did not receive AC treatment were significantly older than those who received AC treatment
(P < 0.05). The tumor location (distance above anal margin) in the AC group was significantly larger than
that in the non-AC group (P < 0.05). Moreover, there was no significant difference in the 5-year DFS and
OS between the two groups. Postoperative AC did not significantly improve the prognosis of patients with
rectal cancer. Age, tumor differentiation, and the number of resected lymph nodes were independent factors
affecting the OS of patients (P < 0.05). Older patients, patients with lower degree of tumor differentiation,
and patients with <12 resected lymph nodes showed worse prognosis (P < 0.05).
Conclusion Patients with rectal cancer whose ypT0-3N0 stage is reduced after neoadjuvant
chemoradiotherapy, especially those without adverse prognostic factors, do not need AC after surgery. |
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