多发性原发性结直肠癌的临床特征、诊断、治疗及预后
Clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma.
作者信息
Wang Hong-Zhi, Huang Xin-Fu, Wang Yi, Ji Jia-Fu, Gu Jin
机构信息
Department of Surgery, Beijing Cancer Hospital, School of Clinical Oncology, Peking University, Beijing 100036, China.
出版信息
World J Gastroenterol. 2004 Jul 15;10(14):2136-9. doi: 10.3748/wjg.v10.i14.2136.
AIM
To investigate the clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinomas (MPCC).
METHODS
A retrospective analysis of 37 patients with MPCC from 1974 to 1998 was carried out.
RESULTS
The incidence of MPCC was 2.74%(37/1 348) in patients with primary colorectal carcinomas, 15 cases of them were patients with synchronous carcinomas (SC) and 22 cases were diagnosed as metachronous carcinomas (MC). Most tumors were located in the right colon and rectum. Fifty-five percent (12/22) of MC were diagnosed within 3 years after tumor resection and 41%(9/22) of MC occurred after 8 years. Radical resections were performed in all patients except for 1 case. The 5-year survival rate of SC was 72.7%(8/11) and that of MC after the first cancer and second cancer was 71.4%(15/21) and 38.9%(7/18), respectively.
CONCLUSION
The results indicate the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and radical resection can increase survival rate of MPCC.
目的
探讨多原发性结直肠癌（MPCC）的临床特征、诊断、治疗及预后。
方法
对1974年至1998年期间37例MPCC患者进行回顾性分析。
结果
原发性结直肠癌患者中MPCC的发病率为2.74%（37/1348），其中15例为同时性癌（SC），22例诊断为异时性癌（MC）。大多数肿瘤位于右半结肠和直肠。55%（12/22）的MC在肿瘤切除后3年内被诊断出，41%（9/22）的MC在8年后发生。除1例患者外，所有患者均行根治性切除术。SC的5年生存率为72.7%（8/11），MC的首次癌症和第二次癌症后的5年生存率分别为71.4%（15/21）和38.9%（7/18）。
结论
结果表明术前全面检查、术中仔细探查及术后定期监测的重要性。早期诊断和根治性切除可提高MPCC的生存率。
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