肛管癌的手术挽救治疗
Surgical salvage therapy of anal cancer.
作者信息
Bai Yue-Kui, Cao Wen-Lan, Gao Ji-Dong, Liang Jun, Shao Yong-Fu
机构信息
Department of General Surgical Oncology, Cancer Hospital of Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
出版信息
World J Gastroenterol. 2004 Feb 1;10(3):424-6. doi: 10.3748/wjg.v10.i3.424.
AIM
To evaluate the results of salvage resection in the management of persistent or locally recurrent anal canal cancer.
METHODS
Details of all patients with anal canal cancer treated from 1978 to 1994 at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) were reviewed retrospectively. Sixteen patients who presented with persistent or locally recurrent anal canal cancer received salvage surgery. Before surgery all of the patients had received radiotherapy alone as their primary treatments.
RESULTS
Of the 16 patients, 14 received salvage abdominoperineal resection (APR) and two had transanal local excision. There were no deaths attributable to operation. Delayed healing of the perineal wound occurred in eight patients. Complications unrelated to the perineal wound were found in five patients. The median follow-up time was 120 (range 5-245) months after salvage surgery. Nine patients died of disease progression, with a median survival time of 16 (range 5-27) months. Six patients had a long-term survival.
CONCLUSION
Salvage resection after radiotherapy can yield a long-time survival in selected patients with anal canal cancer. However it offers little hope to patients with T4 and/or N(2-3) tumors.
目的
评估挽救性切除在持续性或局部复发性肛管癌治疗中的效果。
方法
回顾性分析1978年至1994年在中国医学科学院肿瘤医院接受治疗的所有肛管癌患者的详细资料。16例持续性或局部复发性肛管癌患者接受了挽救性手术。所有患者术前均仅接受了放射治疗作为主要治疗手段。
结果
16例患者中，14例行挽救性腹会阴联合切除术（APR），2例行经肛门局部切除术。无手术相关死亡病例。8例患者会阴部伤口愈合延迟。5例患者出现与会阴部伤口无关的并发症。挽救性手术后中位随访时间为120（5 - 245）个月。9例患者死于疾病进展，中位生存时间为16（5 - 27）个月。6例患者长期存活。
结论
放疗后挽救性切除可使部分肛管癌患者获得长期生存。然而，对于T4和/或N(2 - 3)期肿瘤患者，其生存希望渺茫。
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