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Prognostic Value of Tumor Deposits for Disease-Free Survival in Patients With Stage III Colon Cancer: A Post Hoc Analysis of the IDEA France Phase III Trial (PRODIGE-GERCOR)
Journal of Clinical Oncology ( IF 42.1 ) Pub Date : 2020-05-20 , DOI: 10.1200/jco.19.01960
Jean-François Delattre 1 , Romain Cohen 1, 2 , Julie Henriques 3, 4 , Antoine Falcoz 3, 4 , Jean-François Emile 5, 6 , Serge Fratte 7 , Benoist Chibaudel 8 , Jérôme Dauba 9 , Olivier Dupuis 10 , Yves Bécouarn 11 , Frédéric Bibeau 12 , Julien Taieb 13 , Christophe Louvet 14 , Dewi Vernerey 3, 4 , Thierry André 1, 2 , Magali Svrcek 2, 15
Affiliation  

PATIENTS AND METHODS A post hoc analysis of all pathologic reports from patients with stage III CC included in the IDEA France phase III study (ClinicalTrials.gov identifier: NCT00958737) investigating the duration of adjuvant fluorouracil, leucovorin, and oxaliplatin or capecitabine and oxaliplatin therapy (3 v 6 months) was performed. The primary objective was to determine the prognostic impact of TD on disease-free survival (DFS). The effect of the addition of TD to LNM count on pN restaging was also evaluated. A multivariable analysis was performed to establish the association between TD and DFS. RESULTS Of 1,942 patients, 184 (9.5%) had TDs. The pN1a/b and pN1c populations showed similar DFS. TD-positive patients had worse prognosis compared with TD-negative patients, with 3-year DFS rates of 65.6% (95% CI, 58.0% to 72.1%) and 74.7% (95% CI, 72.6% to 76.7%; P = .0079), respectively. On multivariable analysis, TDs were associated with a higher risk of recurrence or death (hazard ratio [HR], 1.36; P = .0201). Other adverse factors included pT4 and/or pN2 disease (HR, 2.21; P < .001), the 3 months of adjuvant treatment (HR, 1.29; P = .0029), tumor obstruction (HR, 1.28; P = .0233), and male sex (HR, 1.24; P = .0151). Patients restaged as having pN2 disease (n = 35, 2.3%) had similar DFS as patients initially classified as pN2. CONCLUSION The presence of TDs is an independent prognostic factor for DFS in patients with stage III CC. The addition of TD to LNM may help to better define the duration of adjuvant therapy.

中文翻译:

肿瘤沉积对 III 期结肠癌患者无病生存的预后价值:IDEA France III 期试验 (PRODIGE-GERCOR) 的事后分析

患者和方法 对 IDEA France III 期研究(ClinicalTrials.gov 标识符:NCT00958737)中包括的 III 期 CC 患者的所有病理报告进行事后分析,研究辅助氟尿嘧啶、亚叶酸和奥沙利铂或卡培他滨和奥沙利铂治疗的持续时间( 3 v 6 个月)进行。主要目的是确定 TD 对无病生存 (DFS) 的预后影响。还评估了将 TD 添加到 LNM 计数对 pN 再分期的影响。进行多变量分析以建立 TD 和 DFS 之间的关联。结果 在 1,942 名患者中,184 名 (9.5%) 患有 TD。pN1a/b 和 pN1c 群体表现出相似的 DFS。与 TD 阴性患者相比,TD 阳性患者的预后更差,3 年 DFS 率为 65.6%(95% CI,58.0% 至 72.1%)和 74.7%(95% CI,72.6% 至 76.7%;P = .0079),分别。在多变量分析中,TD 与较高的复发或死亡风险相关(风险比 [HR],1.36;P = .0201)。其他不利因素包括 pT4 和/或 pN2 疾病(HR,2.21;P < .001)、3 个月的辅助治疗(HR,1.29;P = .0029)、肿瘤阻塞(HR,1.28;P = .0233)和男性(HR,1.24;P = .0151)。重新分期为 pN2 疾病的患者(n = 35, 2.3%)与最初分类为 pN2 的患者具有相似的 DFS。结论 TDs 的存在是 III 期 CC 患者 DFS 的独立预后因素。将 TD 添加到 LNM 可能有助于更好地定义辅助治疗的持续时间。其他不利因素包括 pT4 和/或 pN2 疾病(HR,2.21;P < .001)、3 个月的辅助治疗(HR,1.29;P = .0029)、肿瘤阻塞(HR,1.28;P = .0233)和男性(HR,1.24;P = .0151)。重新分期为 pN2 疾病的患者(n = 35, 2.3%)与最初分类为 pN2 的患者具有相似的 DFS。结论 TDs 的存在是 III 期 CC 患者 DFS 的独立预后因素。将 TD 添加到 LNM 可能有助于更好地定义辅助治疗的持续时间。其他不利因素包括 pT4 和/或 pN2 疾病(HR,2.21;P < .001)、3 个月的辅助治疗(HR,1.29;P = .0029)、肿瘤阻塞(HR,1.28;P = .0233)和男性(HR,1.24;P = .0151)。重新分期为 pN2 疾病的患者(n = 35, 2.3%)与最初分类为 pN2 的患者具有相似的 DFS。结论 TDs 的存在是 III 期 CC 患者 DFS 的独立预后因素。将 TD 添加到 LNM 可能有助于更好地定义辅助治疗的持续时间。结论 TDs 的存在是 III 期 CC 患者 DFS 的独立预后因素。将 TD 添加到 LNM 可能有助于更好地定义辅助治疗的持续时间。结论 TDs 的存在是 III 期 CC 患者 DFS 的独立预后因素。将 TD 添加到 LNM 可能有助于更好地定义辅助治疗的持续时间。
更新日期:2020-05-20
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