Significant Clinicopathological Factors for Distant Metastasis of Stage II Colorectal Cancer Patients with Adequate Lymph Node Retrieval and Radical Resection

第二期結直腸癌患者經根治性切除及足夠之淋巴結清除後影響遠處轉移之臨床病理因子

蘇偉智(Wei-Chih Su) ； 蔡祥麟(Hsiang-Lin Tsai) ； 葉永松(Yung-Sung Yeh) ； 黃敬文(Ching-Wen Huang) ； 楊檳輔(Ping-Fu Yang) ； 王照元(Jaw-Yuan Wang)

《中華民國大腸直腸外科醫學會雜誌》 27卷4期 (2016/12) Pp. 139-147

https://doi.org/10.6312/SCRSTW.2016.27(4).10504

摘要

介紹 本研究是確定哪些組織病理與臨床因子會影響第II期大腸直腸癌經根治性切除及足夠的淋巴結清除術後的遠端轉移。方法 我們收集了從2006年1月到2013年10月間在單一機構接受治療的296例第II期大腸直腸癌患者。所有參加試驗的患者皆追蹤至死亡或至2014年12月。並針對影響術後遠端轉移的臨床病理因子進行了分析。結果 使用單變數分析發現5個病理與臨床因子，腫瘤部位(p = 0.001)，血管侵犯(p ＜0.0001)，周邊神經侵犯(p = 0.004)術前血清癌胚抗原值(p ＜ 0.0001)和術後血清癌胚抗原值(p ＜ 0.0001)，被認為是術後遠端轉移的獨立預測因子。使用多變量分析發現，腫瘤部位(p = 0.007)，血管侵犯(p = 0.030)，周邊神經侵犯(p = 0.048)和術後血清癌胚抗原值(p ＜ 0.0001)，被認為是術後遠端轉移的獨立預測因子。討論與結論 本研究顯示，腫瘤部位、血管侵犯、周邊神經侵犯及術後血清癌胚胎抗原值，顯著影響有淋巴結數目截取足夠的第二期大腸直腸癌患者接受根治性切除手術後的遠端轉移。

關鍵字

第二期大腸直腸癌 ； 淋巴結數目截取足夠 ； 臨床病理因子 ； 遠處轉移

並列摘要

Introduction. The aim of the present study was to determine which aspects of tumor histology and clinical features would influence postoperative distant metastasis after radical resection of stage II colorectal cancer (CRC) patients with adequate retrieval of lymph nodes. Materials and Methods. Data was collected for 296 patients with stage II CRC who had radical resection at a single institution between January 2006 and October 2013. All the enrolled patients were followed up on until death or until December 2014. Clinicopathological factors affecting postoperative distant metastases were analyzed. Results. Tumor location in the rectum (p = 0.001), vascular invasion (p ＜ 0.0001), perineural invasion (p = 0.004), preoperative serum carcinoembryonic antigen (CEA) level (p ＜ 0.0001), and postoperative serum CEA level (p ＜ 0.0001) were significant for postoperative distant metastases by a univariate analysis. Using a multivariate analysis, tumor location (p = 0.007), vascular invasion (p = 0.030), perineural invasion (p = 0.048) and postoperative serum CEA level (p ＜ 0.0001) were found to be independent predictors for postoperative distant metastases. Discussion and Conclusions. This current study indicated that tumor location, vascular invasion, perineural invasion and postoperative serum CEA level significantly affected the postoperative distant metastasis of stage II CRC patients following adequate lymph-node retrieval and radical resection.

並列關鍵字

Stage II colorectal cancer ； Adequate lymph nodes retrieval ； Clinicopathological features ； Distant metastasis

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