内容紹介
Summary
The effectiveness of lymph node dissection tends to be reduced clinically in elderly patients with colorectal cancer because of physical limitations, such as comorbidities and organ dysfunction. We investigated the influence of the level of lymph node dissection on the prognosis of elderly patients with colorectal cancer. A total of 137 patients with pT2 or more-advanced tumors or lymph node metastasis were retrospectively studied. The 5-year overall survival(OS)and relapse free survival(RFS)rates were 74.1% and 63.9%, respectively. Lymph node dissection was an independent prognostic factor in the examination of prognostic factors of OS. In the propensity-matched cohort, the 5-year OS rates were 87.2% and 58.2%(p=0.02), and the 5-year RFS rates were 77.8% and 46.4%(p=0.03)in the D3 and reduced groups, respectively. The D3 group had a significantly better prognosis than the reduced group. D3 lymph node dissection might contribute to the improvement of prognosis in elderly people with colorectal cancer.
要旨
高齢者大腸癌症例では併存疾患や臓器機能低下など身体的制限から,臨床的にリンパ節郭清を縮小する傾向にある。高齢者大腸癌手術におけるリンパ節郭清度が予後に与える影響について検討を行った。pT2以深またはリンパ節転移陽性であった137例を対象とした。5年全生存率(overall survival: OS),5年無再発生存率(relapse free survival: RFS)はそれぞれ74.1%,63.9%であった。OSに対する予後因子の検討では,リンパ節郭清度が独立した予後因子であった。傾向スコアマッチングによる43例ずつでの長期成績の検討では,5年OS(D3群87.2%vs縮小群58.2%,p=0.02),5年RFS(77.8% vs 46.4%,p=0.03)で,いずれもD3群が縮小群よりも有意に予後良好であった。高齢者大腸癌手術においてD3リンパ節郭清は予後の向上に寄与する可能性が示唆された。
目次
The effectiveness of lymph node dissection tends to be reduced clinically in elderly patients with colorectal cancer because of physical limitations, such as comorbidities and organ dysfunction. We investigated the influence of the level of lymph node dissection on the prognosis of elderly patients with colorectal cancer. A total of 137 patients with pT2 or more-advanced tumors or lymph node metastasis were retrospectively studied. The 5-year overall survival(OS)and relapse free survival(RFS)rates were 74.1% and 63.9%, respectively. Lymph node dissection was an independent prognostic factor in the examination of prognostic factors of OS. In the propensity-matched cohort, the 5-year OS rates were 87.2% and 58.2%(p=0.02), and the 5-year RFS rates were 77.8% and 46.4%(p=0.03)in the D3 and reduced groups, respectively. The D3 group had a significantly better prognosis than the reduced group. D3 lymph node dissection might contribute to the improvement of prognosis in elderly people with colorectal cancer.
要旨
高齢者大腸癌症例では併存疾患や臓器機能低下など身体的制限から,臨床的にリンパ節郭清を縮小する傾向にある。高齢者大腸癌手術におけるリンパ節郭清度が予後に与える影響について検討を行った。pT2以深またはリンパ節転移陽性であった137例を対象とした。5年全生存率(overall survival: OS),5年無再発生存率(relapse free survival: RFS)はそれぞれ74.1%,63.9%であった。OSに対する予後因子の検討では,リンパ節郭清度が独立した予後因子であった。傾向スコアマッチングによる43例ずつでの長期成績の検討では,5年OS(D3群87.2%vs縮小群58.2%,p=0.02),5年RFS(77.8% vs 46.4%,p=0.03)で,いずれもD3群が縮小群よりも有意に予後良好であった。高齢者大腸癌手術においてD3リンパ節郭清は予後の向上に寄与する可能性が示唆された。