- 期刊
The Survival of Stage II Colorectal Cancer Patients is Significantly Affected by the Numbers of Lymph Node Retrieval
轉移淋巴結比率對第二期大腸直腸癌病人總體存活率的影響
摘要
目的：淋巴結轉移的數量是大腸直腸癌的重要預後因子。然而，轉移淋巴結佔所有淋巴結的比率跟大腸直腸癌總體存活的關係仍是值得探討的，特別是針對淋巴結摘取不到12的顆病人。方法：本研究採回溯分析2006年至2011年所有接受手術治療之大腸直腸癌病人，共計486位。根據轉移淋巴結摘取比率，將研究的病人分成2組：第1組病人摘取淋巴結數少於12顆者（n=107）；第2組病人摘取淋巴結數大於等於12顆者（n=379）。進而分析轉移淋巴結摘取比率與總體存活率之影響。結果：兩組病人的年齡、性別、腫瘤位置與病理型態相似。第1組病人平均存活為52個月，第2組病人平均存活為60個月；在第2期大腸直腸癌病人中（n=120），第1組病人（n=20）平均存活為56個月，第2組病人（n=100）平均存活為72個月（P=0.03）；研究發現第2組的病人有較多的T3侵犯（P=0.04）其次腫瘤位置以位居乙狀結腸居多（P=0.01）。結論：針對第2期之大腸直腸癌，轉移淋巴結比率為大腸直腸癌重要的預後因子，特別是淋巴結摘除數大於等於12顆者跟大腸直腸癌之總體存活相關，建議執行大腸直腸癌根治性手術， 淋巴結摘除數大於等於12顆者為外科手術治療之重要指標。
並列摘要
Objective: Lymph node removal has been an important component in surgical treatment of colorectal cancer (CRC). The diagnosis of a lymph node negative CRC should imply a good prognosis. However, the relationship between the metastatic to examined lymph nodes and overall survival in CRC patients is worth investigation, especially on numbers of retrieved lymph nodes less than 12. Methods: We retrospectively reviewed the records of 486 patients with adenocarcinoma of the CRC who had surgical intervention with curative intent between 2006 and 2011. Patients were divided into two groups: group I patients had ＜12 (n=107) and group II patients had ≧12 (n=379) LN reported. Results: The two groups were similar in age, gender distribution, tumor locations and pathological grading. The median survival was 52 and 60 months for groups I and II, respectively. In stage II patients (n=120), median survival was 56 months for group I (n=20) and 72 months for group II (n=100) (P=0.03). Group II patients also had more T3 depth of tumor invasion (P =0.04) and tumor location in the sigmoid colon (P=0.01). Conclusions: For stage II disease, removal of ≧12 LN appears to contribute to a considerable survival. For patients with stage II CRC, lymph node removed might be considered as a crucial prognostic factor. Especially, while the number of retrieved nodes is under 12, we suggest recommend in curative resections of CRC.