课件：结肠癌NCCN解读.ppt

手术治疗是关键，淋巴结检查数量12; III期与高危II期患者需要奥沙利铂方案辅助化疗; 卡培他滨有利于降低骨髓毒性； 奥沙利铂或伊立替康方案一线化疗，并可互为二线; 贝伐珠和西妥昔（联合伊立替康）一线化疗; 打打停停有利于提高患者的生活质量； 三药方案提高近期有效率，增加手术机会。 小 结 * NCCN 2010 - China - Colon * The pooled dataset provides in total 1027 patients from 6 clinical trials. Again, approximately 50% of the patients are stage II, and the overall proportion of patients with dMMR tumors is 16%. * NCCN 2010 - China - Colon * Here we present disease free survival data in patients with dMMR tumors, by stage, from the pooled dataset. In patients with stage II disease, there was a strong trend toward worsened disease free survival with treatment compared to control, with a p-value of 0.05 and a hazard ratio of 2.8. No benefit from treatment was observed in dMMR patients with stage III disease, with the survival curves essentially overlapping. * NCCN 2010 - China - Colon * In patients with pMMR tumors, we observe a highly significant benefit from treatment observed in patients with stage III disease, where treatment significantly improved the 5 year DFS, with a p-value of 0.001 and a hazard ratio of 0.6. No significant difference based on treatment was observed in dMMR patients with stage II disease, again not surprising given the sample size and modest overall benefit in these patients. * * O’Connell and colleagues evaluated surveillance, epidemiology, and end results (SEER) records from 119,363 patients with colon cancer diagnosed between January 1, 1991, and December 31, 2001 Overall 5-year colon cancer-specific survival for the entire cohort was 65.2% The 5-year overall survival for stage IIIa colon cancer (83.4%) was significantly better than that for stage IIb colon cancer (72.2%; P0.001) Cancer staging used in this study was based on the sixth revised edition of the Cancer Staging Manual issued by the American Joint Committee on Cancer (AJCC) The SEER program collects patient records from multiple sites across the United States and is regarded as a model population-based tumor regi