| 张大奎,王本军,李 明.辅助化疗对ypⅠ期直肠癌患者术后生存的影响[J].肿瘤学杂志,2015,21(1):9-13. |
| 辅助化疗对ypⅠ期直肠癌患者术后生存的影响 |
| Influence of Adjuvant Chemotherapy on Survival in Patients with Rectal Cancer Stage Ⅰ After Neoadjuvant Therapy |
| 投稿时间：2014-09-17 |
| DOI：10.11735/j.issn.1671-170X.2015.01.B003 |
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| 中文关键词: 直肠肿瘤 新辅助治疗 降期 预后 外科手术 辅助化疗 |
| 英文关键词:rectal neoplasms neoadjuvant therapy downstaging prognosis surgery adjuvant chemotherapy |
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| 中文摘要: |
| 摘 要：［目的］ 比较Ⅰ期直肠癌与新辅助治疗后降期为ypT1~2N0M0的cT3~4或N+的直肠癌患者5年总生存率的差异。［方法］ 回顾分析105例直肠癌根治术后病理分期为T1~2N0M0的直肠癌患者的临床病理资料及随访资料。按患者是否行新辅助治疗和辅助化疗分为3组。单纯手术组（A组）：未经术前新辅助治疗，pT1~2N0M0的早期直肠癌患者（29例）。新辅助降期化疗组（B1组）：初始诊断为cT3~4或N+，术前行新辅助治疗后降期为ypT1~2N0M0，且术后行辅助化疗的直肠癌患者（54例）。新辅助降期非化疗组（B2组）：初始诊断为cT3~4或N+，术前行新辅助治疗后降期为ypT1~2N0M0，且术后未行辅助化疗的直肠癌患者（22例）。对3组生存情况进行分析。［结果］ 新辅助治疗后降期为T1~2N0M0的直肠癌患者（B1+B2组）术后5年生存率为94.0%。单纯手术组（A组）患者术后5年生存率为91.0%，新辅助降期化疗组（B1组）为88.9%，新辅助降期非化疗组（B2组）为90.9%。单因素分析提示3组预后差异无统计学意义（P>0.05）。［结论］ 新辅助治疗后降期为T1~2N0M0的直肠癌患者无论是否行术后化疗都可获得与Ⅰ期直肠癌患者相同的预后。新辅助治疗后降期为T1~2N0M0直肠癌患者术后化疗并未能提高患者5年总生存率。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the 5-year survival between rectal cancer patients with initial stage Ⅰ and stage cT3～4 or N+ patients downstaging to ypT1~2N0M0 after neoadjuvant therapy .［Methods］ One hundred and five rectal cancer patients with pathological stage T1~2N0M0 after radical resection were retrospectively analyzed. They were divided into three groups according to with or without neoadjuvant therapy and adjuvant chemotherapy. Group A(n=29)： patients with surgery alone ，without neoadjuvant therapy，pT1~2N0M0. Group B1(n=54)：initially diagnosed as stage cT3～4 or N+，downstaging to ypT1~2N0M0 after neoadjuvant therapy，and receiving postoperative adjuvant chemotherapy. Group B2(n=22)： initially diagnosed as stage cT3～4 or N+，downstaging to ypT1~2N0M0 after neoadjuvant therapy，without postoperative adjuvant chemotherapy. Survivals in 3 groups were analyzed.［Results］ The 5-year overall survival rate in patients downstaging to ypT1~2N0M0 after neoadjuvant therapy (group B1+group B2)was 94.0%. And the 5-year overall survival rate was 91.0%，88.9% and 90.9% in group A，group B1 and group B2 respectively. Univariate analysis showed no significant difference of prognosis among the 3 groups.［Conclusion］ No matter with or without postoperative adjuvant chemotherapy ，rectal cancer patients downstaging to ypT1~2N0M0 after neoadjuvant therapy might have the similar prognosis to initial stage Ⅰ patients . Patients with neoadjuvant therapy will not benefit from adjuvant chemotherapy. |
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