第二期大腸癌病人開刀後存活分析：著眼於化學治療－單一醫學中心的經驗

Survival of Resectable Stage II Colon Cancer Patients: Focus on Chemotherapy-Experience from a Single Institution

10.6323/JCRP.2015.2.4.3

劉惠文(Hui-Wen Liu)；李興中(Henry Hsin-Chung Lee)；宋詠娟(Yung-Chuan Sung)

第二期大腸癌 ； 存活率 ； 輔助性化學治療 ； 左右側大腸癌 ； stage II colon cancer ； overall survival ； adjuvant chemotherapy ； left and right side colon cancer

台灣癌症醫學雜誌

2卷4期（2015 / 12 / 01）

293 - 300

英文

背景：第二期大腸癌病人開刀後的輔助性化學治療目前尚無明確的定位，多以具高危險因子之病患接受化療為目前共識，我們根據本院癌症資料庫回溯分析第二期大腸癌病人治療狀況，進而得知輔助性化學治療的角色。材料與方法：根據國泰綜合醫院癌症登記資料庫，癌症登記2007年至2012年病理期別為第二期的大腸癌患者，共176名個案，統計總存活時間及各族群間存活比較。結果：病人平均追蹤時間為40.37個月，第二期大腸癌是否接受術後輔助性化療的存活分析，有接受化療之存活顯著較未接受化療者佳（p=0.003），三年存活率為82%比上61%（p=0.004），左側大腸癌接受化療之存活顯著較未接受化療者佳（HR 0.093，p=0.002），男性接受化療之存活顯著較未接受化療者佳（HR 0.216，p=0.010）。結論：根據本院資料庫分析，除了傳統共識中的高危險因子外，第二期左側大腸癌病人可建議術後輔助性化學治療以改善存活時間。

Background: Adjuvant chemotherapy for stage II resectable colon cancer has not been found to impact outcome. Most of the benefit of adjuvant therapy was seen in high-risk stage II disease. We analyzed the survival data from the cancer registry database of our institution to determine the efficacy of adjuvant chemotherapy in stage II colon cancer patients. Materials and Methods: From 2007 to 2012, 176 patients with resectable stage II colon cancer were treated at CGH. Overall survival (OS) analysis and sub-group analysis were performed. Results: Mean follow-up was 40.37 months. Survival of stage II colon cancer was superior in patients receiving adjuvant chemotherapy than in those without chemotherapy (p=0.003). Three-year OS was 82% vs. 61% (p=0.004). Survival was better in patients with left side colon cancer receiving chemotherapy (HR 0.093, p=0.002) and in male patients receiving chemotherapy (HR 0.216, p=0.010). Conclusions: Based on our study results, we recommend adjuvant chemotherapy in patients with stage II left side colon cancer in addition to in patients with high risk stage II colon cancer.