辅助化疗对ypⅠ期直肠癌患者术后生存的影响

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[目的]比较Ⅰ期直肠癌与新辅助治疗后降期为yp T1~2N0M0的c T3~4或N+的直肠癌患者5年总生存率的差异。[方法]回顾分析105例直肠癌根治术后病理分期为T1~2N0M0的直肠癌患者的临床病理资料及随访资料。按患者是否行新辅助治疗和辅助化疗分为3组。单纯手术组(A组):未经术前新辅助治疗,p T1~2N0M0的早期直肠癌患者(29例)。新辅助降期化疗组(B1组):初始诊断为c T3~4或N+,术前行新辅助治疗后降期为yp T1~2N0M0,且术后行辅助化疗的直肠癌患者(54例)。新辅助降期非化疗组(B2组):初始诊断为c T3~4或N+,术前行新辅助治疗后降期为yp T1~2N0M0,且术后未行辅助化疗的直肠癌患者(22例)。对3组生存情况进行分析。[结果]新辅助治疗后降期为T1~2N0M0的直肠癌患者(B1+B2组)术后5年生存率为94.0%。单纯手术组(A组)患者术后5年生存率为91.0%,新辅助降期化疗组(B1组)为88.9%,新辅助降期非化疗组(B2组)为90.9%。单因素分析提示3组预后差异无统计学意义(P>0.05)。[结论 ]新辅助治疗后降期为T1~2N0M0的直肠癌患者无论是否行术后化疗都可获得与Ⅰ期直肠癌患者相同的预后。新辅助治疗后降期为T1~2N0M0直肠癌患者术后化疗并未能提高患者5年总生存率。 [Objective] To compare the 5-year overall survival rate of rectal cancer patients with c T3~4 or N+ with yp T1~2N0M0 after stage I neoadjuvant treatment and rectal cancer. [Methods] The clinical and pathological data and follow-up data of 105 patients with rectal cancer who underwent radical resection of T1~2N0M0 were retrospectively analyzed. Patients were divided into three groups according to whether they were neoadjuvant and adjuvant chemotherapy. Surgical group (group A): No neoadjuvant preoperative treatment, p T1 ~ 2N0M0 patients with early rectal cancer (29 cases). Neoadjuvant chemotherapy in the late-stage chemotherapy group (group B1): initial diagnosis of cT3~4 or N+, neoadjuvant treatment after surgery was decomposed to yp T1~2N0M0, and postoperative adjuvant chemotherapy for rectal cancer (54 cases) . Neoadjuvant chemotherapy in the non-chemotherapy group (group B2): initial diagnosis of cT3~4 or N+, neoadjuvant treatment followed by a reduction in yp T1~2N0M0 before surgery, and rectal cancer patients who did not receive adjuvant chemotherapy (22) example). Analysis of the survival of the three groups. [Results] The 5-year survival rate of rectal cancer patients (B1+B2 group) after neoadjuvant therapy was T1~2N0M0 was 94.0%. The 5-year survival rate was 91.0% in the simple surgery group (A group), 88.9% in the neoadjuvant chemotherapy (B1 group), and 90.9% in the non-chemotherapy group (B2 group). Univariate analysis suggested that there was no statistical difference in the prognosis of the three groups (P>0.05). [Conclusion] Patients with rectal cancer with T1~2N0M0 after neoadjuvant therapy can achieve the same prognosis as those with stage I rectal cancer whether or not they undergo postoperative chemotherapy. After neoadjuvant therapy, T1~2N0M0 patients with rectal cancer who had been treated with postoperative chemotherapy did not improve their 5-year overall survival.
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