BACKGROUND Adjuvant chemotherapy(ACTx)is recommended in rectal cancer patients after preoperative chemoradiotherapy(PCRT),but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is...BACKGROUND Adjuvant chemotherapy(ACTx)is recommended in rectal cancer patients after preoperative chemoradiotherapy(PCRT),but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial.AIM To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection.METHODS We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014.Patients with ypT0–1 disease and those who received ACTx were included.The 5-year overall survival(OS)and 5-year recurrence-free survival(RFS)were analyzed according to the status of the ACTx.RESULTS Of 520 included patients,413 received ACTx(ACTx group)and 107 did not(no ACTx group).No significant difference was observed in 5-year RFS(ACTx group,87.9%vs no ACTx group,91.4%,P=0.457)and 5-year OS(ACTx group,90.5%vs no ACTx group,86.2%,P=0.304)between the groups.cT stage was associated with RFS and OS in multivariate analysis[hazard ratio(HR):2.57,95%confidence interval(CI):1.07–6.16,P=0.04 and HR:2.27,95%CI:1.09–4.74,P=0.03,respectively].Furthermore,ypN stage was associated with RFS and OS(HR:4.74,95%CI:2.39–9.42,P<0.00 and HR:4.33,95%CI:2.20–8.53,P<0.00,respectively),but only in the radical resection group.CONCLUSION Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement,regardless of the radicality of resection.Further trials are needed to evaluate the efficacy of ACTx in these group of patients.展开更多
文摘BACKGROUND Adjuvant chemotherapy(ACTx)is recommended in rectal cancer patients after preoperative chemoradiotherapy(PCRT),but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial.AIM To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection.METHODS We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014.Patients with ypT0–1 disease and those who received ACTx were included.The 5-year overall survival(OS)and 5-year recurrence-free survival(RFS)were analyzed according to the status of the ACTx.RESULTS Of 520 included patients,413 received ACTx(ACTx group)and 107 did not(no ACTx group).No significant difference was observed in 5-year RFS(ACTx group,87.9%vs no ACTx group,91.4%,P=0.457)and 5-year OS(ACTx group,90.5%vs no ACTx group,86.2%,P=0.304)between the groups.cT stage was associated with RFS and OS in multivariate analysis[hazard ratio(HR):2.57,95%confidence interval(CI):1.07–6.16,P=0.04 and HR:2.27,95%CI:1.09–4.74,P=0.03,respectively].Furthermore,ypN stage was associated with RFS and OS(HR:4.74,95%CI:2.39–9.42,P<0.00 and HR:4.33,95%CI:2.20–8.53,P<0.00,respectively),but only in the radical resection group.CONCLUSION Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement,regardless of the radicality of resection.Further trials are needed to evaluate the efficacy of ACTx in these group of patients.
文摘[背景]近年来,随着猕猴桃种植面积的不断扩大,病害的频繁发生已逐渐影响猕猴桃的产量和品质。恶疫霉(Phytophthora cactorum)、樟疫霉(P.cinnamomi)和雪松疫霉(P.lateralis)是一类可以引起猕猴桃根腐病的致病疫霉菌。[目的]建立并优化可以同时检测3种致病疫霉的多重实时定量检测技术,并调查猕猴桃主要产区的致病菌分布情况。[方法]基于Ypt1 (ras-related protein gene)基因设计恶疫霉、樟疫霉和雪松疫霉的特异性TaqMan探针和引物,建立并优化多重实时荧光定量PCR检测体系。利用近缘种检验检测体系特异性并进行灵敏度测试,应用该检测体系分析猕猴桃主要产区根际土壤中3种致病疫霉的Yt1基因含量。[结果]供测试的11个恶疫霉近缘种、11个樟疫霉近缘种、13个雪松疫霉近缘种及非目标菌种DNA样品中均无荧光信号,反应结果为阴性,而在恶疫霉、樟疫霉和雪松疫霉DNA样品中分别检测出HEX、FAM和ROX荧光信号,反应结果为阳性。三种疫霉的检测灵敏度均达到100fg。此外,通过对猕猴桃主产区陕西省周至县和眉县果园共166份土壤样品的检测发现,恶疫霉的分布最广泛且Ypt1基因含量最高,樟疫霉和雪松疫霉则相对较少。[结论]建立的猕猴桃根腐病致病疫霉多重实时定量检测体系特异性强、灵敏度高,适合于恶疫霉、樟疫霉和雪松疫霉的检测及定量分析。该技术可为猕猴桃疫霉病害的早期诊断、监测及预防提供指导。
