4.6 Article

The clinic factors in evaluating long-term outcomes of patients with stage I colorectal cancer

期刊

ASIAN JOURNAL OF SURGERY
卷 45, 期 11, 页码 2231-2238

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ELSEVIER SINGAPORE PTE LTD
DOI: 10.1016/j.asjsur.2021.11.055

关键词

Colorectal cancer; Recurrence; Surveillance; Risk factor

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资金

  1. Ministry of Science and Technology of the People's Republic of China [2017YFC0908204]
  2. Department of Science and Technology of Sichuan Province [2021YFS0025]
  3. 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University [20HXJS003]
  4. 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project
  5. West China Hospital, Sichuan University [2019HXFH031]

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This study investigated the survival and recurrence of stage I colorectal cancer (CRC) patients. The analysis of preoperative serological values revealed that age, white blood cell count, and the systemic inflammation index (SII) were associated with overall survival (OS), while elevated carcinoembryonic antigen (CEA) levels were related to disease-free survival (DFS). These findings suggest that stage I CRC patients still carry a clinically significant risk of recurrence, and further validation is needed to identify high-risk patients with less severe disease.
Background: This study aimed to explore the survival and recurrences of stage I colorectal cancer (CRC) patients. Through the analysis of the results of preoperative serological values, we seek to find factors associated with the survival and recurrence of patients with stage I CRC. Methods: We retrospectively enrolled patients from 2012 January to 2015 April. Survival rates were calculated with the Kaplan-Meier method and survival curves were compared using the log-rank test. The independent prognostic factors were assessed by the Cox proportional hazard regression analysis. Results: A total of 476 patients with stage I disease were included to analysis. Median follow-up was 68 months (4-84 months) for OS. The OS rates were related to age,CEA, CHOL, LDL-C levels,HBDH, WBC, NLR, LMR, LWR, PNI, SII, NPS and CONUT at univariate analysis. At multivariate analysis, age, WBC and SII were confirmed to be independent prognostic factors for OS. The median DFS was 68 months (2-84 months). In this period, 38 (8.0%) experienced tumor relapse, and 17 (44.7%) died due to recurrence. The DFS rates were related to higher CEA, higher NLR values and lower LMR values at univariate analysis. At multivariate analysis, just elevated CEA levels was confirmed to be independent prognostic factors. Conclusions: Patients with stage I colorectal cancers still have a clinically significant risk of recurrence. We still need to expand the number of cases to validate our findings and better identify patients who are at high risk of relapse with less severe disease. (C) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.

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