浙江医学2017，Vol.39Issue(13)：1048-1052,5.DOI:10.12056/j.issn.1006-2785.2017.39.13.2016-830
局部进展期中低位直肠癌新辅助治疗后淋巴结变化及与预后的关系
Prognostic value of lymph node status after neoadjuvant chemoradiation therapy in patients with locally advanced mid-low rectal cancer
摘要
Abstract
Objective To investigate the associationof lymph node status after neoadjuvant chemoradiation therapy (NCRT) in patients with locally advanced rectal cancer (LARC).Methods Clinical data of 216 patients with IARC receiving radical tumor resection were analysized retrespectively,including 106 patients (study group) with NCRT followed by radical tumor resection 110 patients (control group) undergoing primary surgery without NCRT.The total lymph nodes (LNs) retrieval and the number of positive LNs was compared between the two groups.The correlation between T stage and radiosensitivity was analysized,and the association of LN status with prognosis of patients was evaluated with Kaplan-Meier survival curve.Results The number of total LNs and positive LNs harvested from each resected specimen in the control group were 10.62 ± 0.36 and 2.32 ± 0.33,while those were 8.12 ± 0.38 and 0.84 ± 0.12 in study group (P＜0.001 and P=0.04).T stage was associated with the tumor pathological response after NCRT(r=0.97,P＜0.01).In study group,the 5-year overall survival rate in patients with negative LNs was significantly higher than that in patients with positive LNs (78.0％ vs 50.4％,x2=8.836,P=0.003),however,there was no significant difference in the overall survival between patients with ≥ 12 Lns andthose with ＜12 LNs (80.8％ vs 63.0％,x2=0.164,P=0.686).Conclusion NCRT reduces the number of LNs retrieval and the positive LNs in LARC;negative LNs after NCRT may improve the prognosis of LARC patients.关键词
直肠肿瘤/新辅助治疗/淋巴结状况Key words
Rectal neoplasm/Neoadjuvant chemoradiation therapy/Lymph node status引用本文复制引用
左志贵,王颢,高显华,于志奇,张畅,柴瑞,傅传刚..局部进展期中低位直肠癌新辅助治疗后淋巴结变化及与预后的关系[J].浙江医学,2017,39(13):1048-1052,5.基金项目
国家自然科学基金资助项目(30973460,81272561) （30973460,81272561）
浙江省医药卫生科技计划资助项目(2015KYA153) （2015KYA153）
温州市科技局科研基金资助项目(Y20140372,Y20150710) （Y20140372,Y20150710）
