结肠癌术后辅助化疗患者远期生存状况和预后危险因素分析

Analysis of long-term survival status and prognostic risk factors of postoperative adjuvant chemotherapy in patients with colon cancer

目的探究结肠癌术后辅助化疗患者的远期生存状况及其预后危险因素。方法回顾性分析2013年2月至2014年2月于青岛市市立医院行术后辅助化疗的98例结肠癌患者的临床资料,记录患者化疗相关不良反应发生情况及其生存状况,采用Kaplan-Meier生存曲线分析患者5年生存率,采用多因素Logistic回归分析影响结肠癌术后辅助化疗患者预后的危险因素。结果98例患者均顺利完成化疗,其不良反应主要以中性粒细胞减少(78例)和恶心呕吐(59例)居多,其次为口腔黏膜炎(26例)、手足麻木(18例)、腹泻(17例)、血小板减少(10例),均为Ⅰ~Ⅱ级,未影响治疗。随访5年,98例结肠癌患者1、3、5年生存率分别为87.76%、71.43%、62.24%。死亡组和存活组患者美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)评分、组织分化程度、淋巴结转移数目、脉管侵犯情况、临床分期及术前癌胚抗原(carcinoembryonic antigen,CEA)水平比较差异均具有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示:组织分化程度低、淋巴结转移数目≥4个、临床分期Ⅲ期及术前CEA水平≥5μg/L是影响结肠癌术后辅助化疗患者预后的独立危险因素(均P<0.05)。结论结肠癌术后辅助化疗患者5年生存率为62.24%,组织分化程度低、淋巴结转移数目≥4个、临床分期Ⅲ期及术前CEA水平≥5μg/L是影响结肠癌术后辅助化疗患者预后的独立危险因素。

Objective To investigate the long-term survival status and prognostic risk factors of postoperative adjuvant chemotherapy in patients with colon cancer.Method The clinical data of 98 patients with colon cancer who received postoperative adjuvant chemotherapy in Qingdao Municipal Hospital from February 2013 to February 2014 were analyzed retrospectively,and the occurrence and survival status of chemotherapy-related adverse reactions were recorded,Kaplan-Meier survival curve was used to analyze the 5-year survival rate,and multivariate Logistic regression was used to analyze the risk factors affecting the prognosis of patients with colon cancer after adjuvant chemotherapy.Result All the 98 patients completed chemotherapy successfully.The main adverse reactions were neutropenia(78 cases)and nausea and vomiting(59 cases),this was followed by oral mucositis(26 cases),hand and foot numbness(18 cases),diarrhea(17 cases)and thrombocytopenia(10 cases),all of which were gradeⅠ~Ⅱand did not affect the treatment.During the 5-year follow-up,the 1-,3-and 5-year survival rates of 98 patients with colon cancer were 87.76%,71.43%and 62.24%,respectively.There were significant differences in Eastern Cooperative Oncology Group(ECOG)score,tissue differentiation,number of lymph node metastasis,vascular invasion,clinical stage and preoperative carcinoembryonic antigen(CEA)level between death group and survival group(all P<0.05).The results of multivariate Logistic regression analysis showed that low tissue differentiation,more than 4 lymph node metastases,clinical stageⅢand preoperative CEA level≥5μg/L were independent risk factors affecting the prognosis of postoperative adjuvant chemotherapy patients with colon cancer.Conclusion The 5-year survival rate of patients with postoperative adjuvant chemotherapy for colon cancer was 62.24%.Low degree of tissue differentiation,more than 4 lymph node metastases,clinical stageⅢand preoperative CEA level≥5μg/L were independent risk factors affecting the prognosis of patients with postoperative adjuvant chemotherapy.