Metastatic Mucinous Colorectal Cancer: An Important Subtype of Colorectal Cancer with Poor Response to Chemotherapy and Overall Survival

轉移性黏液型大腸直腸癌─重要的組織學子型可反映較差的化學治療效果以及預後

蘇祐立(Yu-Li Su) ； 劉建廷(Chien-Ting Liu) ； 邱泰然(Tai-Jan Chiu) ； 李劭軒(Shan-Hsuan Li) ； 黃泰霖(Tai-Lin Huang) ； 陳彥仰(Yen-Yang Chen) ； 唐曄(Yen Tang) ； 饒坤銘(Kun-Ming Rau) ； 黃承華(Cheng-Hua Huang)

《台灣癌症醫學雜誌》 26卷6期 (2010/12) Pp. 221-230

https://doi.org/10.6323/JoCRP.2010.26.6.1

摘要

背景：研究黏液型與非黏液型大腸直腸癌對於化學治療的反應以及存活率的差異。病人及研究方法：我們回溯性分析29名轉移性黏液型大腸直腸癌病人，以1：3的比例找到87名年紀，性別，及病理期別相符合的非黏液型大腸直腸癌病人。我們運用單變項及多變項分析方法，來找出對化學治療反應以及最終存活的相關因子。結果：黏液型及非黏液型大腸直腸癌整體的化學治療反應率分別為33%及58%（p=0.128）。在多變項分析去除各種可能干擾的因素後，黏液型大腸直腸癌是預測化療無效的獨立因子（risk ratio, 0.15）。黏液型大腸直腸癌的中位存活期為8 個月，相較於非黏液型（20個月）有較差的存活（p=0.037）。在多變項分析中，黏液型仍是預後較差的獨立因子（hazard ratio, 1.899, p=0.045）。結論：相較於非黏液型大腸直腸癌，轉移性黏液型大腸直腸癌對化學治療反應較差，整體存活期也明顯短於非黏液型。

關鍵字

黏液型大腸直腸癌 ； 化學治療 ； 危險因子 ； 存活率

並列摘要

Background: The purpose of this study was to investigate the specificity of metastatic mucinous colorectal cancer in terms of chemotherapy response and overall survival compared with non-mucinous colorectal adenocarcinoma.Methods: Twenty-nine mucinous-type and eighty-seven non-mucinous colorectal cancer patients were included after matching for age, sex and Duke's stage. Factors associated with chemotherapy response rate and overall survivals were evaluated by univariate Kaplan-Meier analyses or multivariate Cox regression model.Results: The overall response rates for mucinous and non-mucinous cancers were 33% and 58% (p=0.128), respectively. After adjusting for confounding factors, mucinous type was an independent factor to determine efficacy of chemotherapy (risk ratio, 0.15). The median overall survivals in mucinous and non-mucinous tumors were 8 months and 20 months, respectively (p=0.037). In multivariate analysis, mucinous histology was associated with poor prognosis (hazard ratio, 1.899, p=0.045). Conclusions: Metastatic mucinous colorectal cancers were less responsive to chemotherapy and had reduced survival in comparison to non-mucinous colorectal cancers.

並列關鍵字

mucinous colorectal cancer ； chemotherapy ； risk factor ； overall survival