Identification of patients with high-risk lymph node-negative colorectal cancer and potential benefit from adjuvant chemotherapy
| Autor: | Vincenzo Aiello-Crocifoglio, Luis F. Oñate-Ocaña, Cuauhtemoc Oros-Ovalle, Ricardo Mondragón-Sánchez, Dolores Gallardo-Rincón, Rene Montesdeoca, Roberto Herrera-Goepfert, Mario Cortina-Borja, Carlos M. López-Graniel |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Multivariate analysis Time Factors Colorectal cancer Adenocarcinoma Cohort Studies Carcinoembryonic antigen Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged Proportional Hazards Models Retrospective Studies biology Proportional hazards model business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Prognosis Primary tumor Chemotherapy Adjuvant Relative risk Lymphatic Metastasis Cohort biology.protein Female Neoplasm Recurrence Local business Colorectal Neoplasms |
| Zdroj: | Japanese journal of clinical oncology. 34(6) |
| ISSN: | 0368-2811 |
| Popis: | Background: Adjuvant chemotherapy is not indicated in lymph node-negative colorectal adenocarcinoma (CRC), even though some cases will present recurrent disease. It is important to identify a subgroup of patients with the highest risk of relapse because of the potential benefit of adjuvant chemotherapy. The objective of this study is to define the prognostic factors and describe a method for the selection of this subgroup. Methods: A retrospective cohort of 124 patients with lymph node-negative CRC with complete surgical resection was studied. Cox’s proportional hazards model was used to define the prognostic factors associated with CRC-related survival and to develop a method for prediction of recurrence probability. Results: The cohort included 62 women and 62 men with mean age 55.8 years. The mean follow-up period was 11.7 years. T classification of the primary tumor, differentiation grade, carcinoembryonic antigen level, gender and the presence of neural invasion were significant prognostic factors according to the multivariate analysis (final model P = 0.00001). Using risk ratios for these prognostic factors, we defined a high-risk group of 78 patients and a low-risk group of 46 patients with 24 and 5 recurrences, respectively (recurrence rates of 30.8% and 10.9% respectively, P = 0.011). Conclusions: Using these factors, a prognostic scale was developed to predict high risk of recurrence in cases of completely resected CRC and to identify them as a subgroup of patients with potential benefit of adjuvant chemotherapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|