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首页> 美国卫生研究院文献>Journal of the Anus Rectum and Colon >Outcomes of stage IV patients with colorectal cancer treated in a single institution: What is the key to the long-term survival?
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Outcomes of stage IV patients with colorectal cancer treated in a single institution: What is the key to the long-term survival?

机译：在一家机构中接受治疗的IV期结直肠癌患者的结局：长期生存的关键是什么？

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Objectives: The purpose of this study is to summarize our short- and long-term treatment results for stage IV colorectal cancer (CRC) and to clarify the factors predicting the favorable long-term survival. Methods: Between January 2008 and December 2015, 149 consecutive patients with stage IV CRC underwent initial treatment at Nagoya University Hospital. Their clinical and pathological characteristics, the treatment methods used, and the outcomes were retrospectively analyzed. Results: The median observation period was 23 months. All of the primary and metastatic lesions were technically resectable in 74 patients; however, the remaining 75 were judged as initially unresectable. R0/1 resection during the treatment course was achieved in 74 patients (50%). For the cohort as a whole, the 5-year overall survival (OS) rate was 35%. The 5-year OS rate in the R0/1 resection group was 57%, which was significantly better than that of the non-R0/1 resection group (6%, p < 0.001). In the R0/1 resection group, perioperative chemotherapy significantly improved the outcome (5-year OS; 62% vs. 0%, p = 0.03). In the non-R0/1 resection group, primary tumor resection was associated with a significantly higher favorable prognosis (3-year OS; 20.4% vs. 0%, p = 0.026). Moreover, the additional use of molecular targeted drugs significantly improved the survival. In multivariate analysis, the differentiated histologic type, R0/1 resection, and parallel use of molecular targeted drugs remained independent factors of a favorable outcome. Conclusions: The present study suggested that aggressive curative resection with perioperative chemotherapy might improve survival and that primary tumor resection might improve the outcome in the non-R0/1 group.
机译：目的：本研究的目的是总结我们对IV期结直肠癌（CRC）的短期和长期治疗结果，并阐明预测良好长期生存的因素。方法：2008年1月至2015年12月，在名古屋大学医院对149例IV期CRC连续患者进行了初始治疗。回顾性分析其临床和病理特征，所用治疗方法和结果。结果：中位观察期为23个月。从技术上讲，所有原发灶和转移灶都可以切除，其中74例患者。但是，其余75​​人最初被判定为不可切除。 74例患者（50％）在治疗过程中达到了R0 / 1切除。对于整个队列，5年总生存率（OS）为35％。 R0 / 1切除组的5年OS率为57％，显着高于非R0 / 1切除组的6％（p <0.001）。在R0 / 1切除组中，围手术期化疗显着改善了结局（5年OS； 62％vs. 0％，p = 0.03）。在非R0 / 1切除组中，原发肿瘤切除与良好的预后相关（3年OS； 20.4％vs. 0％，p = 0.026）。此外，额外使用分子靶向药物可显着提高生存率。在多变量分析中，分化的组织学类型，R0 / 1切除和并行使用分子靶向药物仍然是取得良好预后的独立因素。结论：本研究提示，在非R0 / 1组中，积极的根治性切除术伴围手术期化疗可提高生存率，而原发性肿瘤切除术可改善预后。

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