直腸癌の側方領域における壁外非連続性癌進展病巣の臨床的意義

• 資料種別: 博士論文
• タイトル: 直腸癌の側方領域における壁外非連続性癌進展病巣の臨床的意義
• 著者・編者: 山井, 大介
• 著者標目: 山井, 大介
• 出版年月日等: 2025-03-24
• 出版年（W3CDTF）: 2025-03-24
• 並列タイトル等: Clinical significance of metastatic tumor deposit foci in rectal cancer in the lateral pelvic lymph node area
• 授与機関名: 新潟大学; Niigata University
• 授与年月日: 2025-03-24
• 授与年月日（W3CDTF）: 2025-03-24
• 報告番号: 甲第5436号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Lateral pelvic lymph node area; Lateral pelvic lymph node dissection; Low rectal cancer; Rectal cancer; Tumor deposit
• 対象利用者: 一般
• 一般注記: BackgroundAlthough previous studies have demonstrated that tumor deposits (TDs) are associated with worse prognosis in colon cancer, their clinical significance in rectal cancer has not been fully elucidated, especially in the lateral pelvic lymph node (LPLN) area. This study aimed to clarify the clinical significance of TDs, focusing on the number of metastatic foci, including lymph node metastases (LNMs) and TDs, in the LPLN area.MethodsThis retrospective study involved 226 consecutive patients with cStage II/III low rectal cancer who underwent LPLN dissection. Metastatic foci, including LNM and TD, in the LPLN area were defined as lateral pelvic metastases (LP-M) and were evaluated according to LP-M status: presence (absence vs. presence), histopathological classification (LNM vs. TD), and number (one to three vs. four or more). We evaluated the relapse-free survival of each model and compared them using the Akaike information criterion (AIC) and Harrell’s concordance index (c-index).ResultsForty-nine of 226 patients (22%) had LP-M, and 15 patients (7%) had TDs. The median number of LP-M per patient was one (range, 1–9). The best risk stratification power was observed for number (AIC, 758; c-index, 0.668) compared with presence (AIC, 759; c-index, 0.665) and histopathological classification (AIC, 761; c-index, 0.664). The number of LP-M was an independent prognostic factor for both relapse-free and overall survival, and was significantly associated with cumulative local recurrence.ConclusionThe number of metastatic foci, including LNMs and TDs, in the LPLN area is useful for risk stratification of patients with low rectal cancer.; Yamai, D., Shimada, Y., Nakano, M. et al. Clinical significance of metastatic tumor deposit foci in rectal cancer in the lateral pelvic lymph node area. Int J Clin Oncol 28, 1388–1397 (2023). https://doi.org/10.1007/s10147-023-02391-1; 新大院博(医)第1248号; 機関リポジトリ記載の権利情報: © The Author(s) under exclusive licence to Japan Society of Clinical Oncology 2023
• 国立国会図書館永続的識別子: info:ndljp/pid/14550459; https://dl.ndl.go.jp/pid/14550459
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2025-11-07T22:06:01+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10191/0002002095
• 異版（URI）: https://doi.org/10.1007/s10147-023-02391-1
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp