| Summary: | 碩士 === 國立臺灣大學 === 臨床醫學研究所 === 106 === Background and aim: The incidence of colorectal cancer(CRC) was rising worldwide. Because the implementation of FIT screening, more and more early-staged CRCs were diagnosed. Therefore, it became an important issue how to manage these early-staged CRC, including stage II CRC. Stage II CRC with high risk features was known beneficial from adjuvant chemotherapy. High risk features included inadequate lymph node retrieval(N<12), tumor perforation before surgery, poorly differentiated histology, T4 tumor, lymphovascular or perineural invasion. However, whether the adjuvant chemotherapy was needed for stage II CRC with mucinous histology remained unknown. Therefore, this study aimed to investigate the difference in disease-free survival (DFS)and overall survival(OS) between stage II CRC with and without mucinous
histology.
Methods: This was a retrospective study and the subjects were enrolled from the list of NTUH cancer registry during 2005 to 2014. A total of 1031 radically resected stage II patients were enrolled. Each case was divided into one of the four groups by histology, including low-grade, high-grade, mucinous and adenocarcinoma with intermediate mucin (AIM) respectively. The recurrence and mortality was checked by chart review. Theprimary endpoint of our study were disease free survival and overall survival. The survival outcomes between different groups were compared with Log-rank test and cox- regression analysis.
Results: The median follow-up period was 50.7 months in the study. The DFS was significantly worse in mucinous in comparison with low-grade counterpart(HR=1.71, 95% CI:1.02-2.88). OS was not significantly different between two groups (HR:1.45, 95% CI: 0.87-2.43). Mucinous histology was an independent risk factor of recurrence (HR:1.78, 95%CI:1.03-3.10) after adjusted by multivariate analysis.
Conclusion: Mucinous histology had worse disease-free survival compared with low- grade adenocarcinoma in this retrospective study. Whether chemotherapy is beneficial for this specific group of patient needs further prospective study.
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