老年高危Ⅱ期和Ⅲ期结直肠癌术后辅助化疗受益分析

Analysis on clinical benefits induced by adjuvant chemotherapy for elderly patients with high risk stage Ⅱ and stage Ⅲ colorectal cancer after radical resection surgery

目的探讨老年高危Ⅱ期和Ⅲ期结直肠癌患者根治术后辅助化疗的临床受益。方法回顾性分析1166例接受过结直肠癌根治术,年龄≥70岁的患者,按术后辅助化疗与未化疗分为两组,应用Kaplan-Meier生存曲线,COX多因素风险模型分析比较两组在无病生存和复发转移方面的差异。结果化疗组和未化疗组的3年总复发和转移率分别为24.4%和40.2%(P<0.05);五年总复发和转移率分别为43.3%和54.1%(P<0.05)。两组三年无病生存率分别为74.9%和57.7%(P<0.05);五年无病生存率分别为56.1%和43.1%(P<0.05)。中位无病生存时间分别为37个月和31个月,前者优于后者(P<0.05)。结论老年高危Ⅱ期和Ⅲ期结直肠癌根治术后进行辅助化疗可降低复发和转移率,延长无病生存期。

Objective To explore the clinical benefits of adjuvant chemotherapy in elderly patients with high risk stageⅡand stageⅢcolorectal cancer after radical resection surgery. Methods This study retrospectively analyzed the clinical data from 1166 patients≥70 years-old who received radical resection surgery. They were divided into chemotherapy group（n=541）and non chemotherapy group（n=625）. the difference in disease-free survival（DFS）, tumor relapse and metastasis rate between two groups was analyzed by Kaplan-Meier method and COX proportional hazard models. Results The 3 years relapse and metastasis rates of two groups were 24.4%and 40.2%, P〈0.05, such as the 5 years were 43.3% and 54.1%, P〈0.05, there were significant differences between the two groups.The 3 years disease-free survival rates of two groups were 74.9%and 57.7%, P〈0.05;such as the 5 years were 56.1%and 43.1%, P〈0.05, the differences were statistically significant.The median disease-free survival time of two groups was 37 months and 31 months, P〈0.05. The difference was statistically significant. Conclusion Adjuvant chemotherapy reduce the relapse and metastasis rates and improve the DFS in elderly patients with high risk stageⅡand stageⅢcolorectal cancer after radical resection surgery.