内容紹介
Summary
In the 9th edition Japanese Classification of Colorectal Carcinoma, Stage Ⅱ and Stage Ⅲ colorectal cancer(CRC)were subdivided by TNM classification on invasion and number of lymph node metastases. We studied prognostic comparison and relation of adjuvant chemotherapy at the new classification. We included 400 cases with resected Ⅱ and Ⅲ CRC from 2007 to 2014. Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc were 97/68/20/24/124/67 cases. Adjuvant chemotherapy was performed at 19/32/45/66/59/70% in Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc, with or without adjuvant chemotherapy at each stage survival rates were compared. In Ⅱa/Ⅱb/Ⅱc, DSS was 97/97/82% and DFS was 89/88/76%, and the prognosis of Ⅱc was significantly worse. In Ⅲa/Ⅲb/Ⅲc, DSS was 95/86/57% and DFS was 82/77/41%. By the presence or absence of adjuvant chemotherapy, significantly differences were obtained at Ⅲb and Ⅲc. Prognosis of Ⅱc was almost same as Ⅲb, and prognosis of Ⅲa was almost same as Ⅱb. Therefore, we considered adjuvant chemotherapy with oxaliplatin should be performed to Ⅱc, Ⅲb, and Ⅲc.
要旨
第9版大腸癌取扱い規約でStage Ⅱ,Stage Ⅲ(以下,Ⅱ,Ⅲ)はTNM分類に準じ深達度・リンパ節転移の個数にて細分化された。当科のⅡ,Ⅲ大腸癌切除症例400例(2007～2014年)の新規約における予後の比較,術後補助化学療法(以下,補助療法)の関連を検討した。内訳はⅡa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc:97/68/20/24/124/67例。補助療法はⅡa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲcで19/32/45/66/59/70%に施行され,各病期でその有無による予後を比較した。Ⅱa/Ⅱb/Ⅱcの5年DSSは97/97/82%,5年DFSは89/88/76%でⅡcの予後が不良であった。Ⅲa/Ⅲb/Ⅲcの5年DSSは95/86/57%,5年DFSは82/77/41%でありⅢcの予後は有意に不良であった。補助療法の有無で有意差が得られたのはⅢbとⅢcのDSSのみであった。Ⅱcの予後はⅢbと同等に悪く,ⅢaはⅡbと同等によい予後であった。したがって,Ⅱc,Ⅲb,Ⅲcにoxaliplatinを加えた補助療法の施行が検討される。
目次
In the 9th edition Japanese Classification of Colorectal Carcinoma, Stage Ⅱ and Stage Ⅲ colorectal cancer(CRC)were subdivided by TNM classification on invasion and number of lymph node metastases. We studied prognostic comparison and relation of adjuvant chemotherapy at the new classification. We included 400 cases with resected Ⅱ and Ⅲ CRC from 2007 to 2014. Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc were 97/68/20/24/124/67 cases. Adjuvant chemotherapy was performed at 19/32/45/66/59/70% in Ⅱa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc, with or without adjuvant chemotherapy at each stage survival rates were compared. In Ⅱa/Ⅱb/Ⅱc, DSS was 97/97/82% and DFS was 89/88/76%, and the prognosis of Ⅱc was significantly worse. In Ⅲa/Ⅲb/Ⅲc, DSS was 95/86/57% and DFS was 82/77/41%. By the presence or absence of adjuvant chemotherapy, significantly differences were obtained at Ⅲb and Ⅲc. Prognosis of Ⅱc was almost same as Ⅲb, and prognosis of Ⅲa was almost same as Ⅱb. Therefore, we considered adjuvant chemotherapy with oxaliplatin should be performed to Ⅱc, Ⅲb, and Ⅲc.
要旨
第9版大腸癌取扱い規約でStage Ⅱ,Stage Ⅲ(以下,Ⅱ,Ⅲ)はTNM分類に準じ深達度・リンパ節転移の個数にて細分化された。当科のⅡ,Ⅲ大腸癌切除症例400例(2007～2014年)の新規約における予後の比較,術後補助化学療法(以下,補助療法)の関連を検討した。内訳はⅡa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲc:97/68/20/24/124/67例。補助療法はⅡa/Ⅱb/Ⅱc/Ⅲa/Ⅲb/Ⅲcで19/32/45/66/59/70%に施行され,各病期でその有無による予後を比較した。Ⅱa/Ⅱb/Ⅱcの5年DSSは97/97/82%,5年DFSは89/88/76%でⅡcの予後が不良であった。Ⅲa/Ⅲb/Ⅲcの5年DSSは95/86/57%,5年DFSは82/77/41%でありⅢcの予後は有意に不良であった。補助療法の有無で有意差が得られたのはⅢbとⅢcのDSSのみであった。Ⅱcの予後はⅢbと同等に悪く,ⅢaはⅡbと同等によい予後であった。したがって,Ⅱc,Ⅲb,Ⅲcにoxaliplatinを加えた補助療法の施行が検討される。