Fuzun Mehmet, Terzi Cem, Sokmen Selman, Unek Tarkan, Haciyanli Mehmet
Department of Surgery, Colorectal Surgery Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Surg Today. 2004;34(11):907-12. doi: 10.1007/s00595-004-2816-3.
Local recurrence after curative surgery for colorectal cancer may be treated by potentially curative surgery, defined as resection of all macroscopic disease. We conducted this retrospective study to show the effectiveness of potentially curative resection for patients with locoregional recurrence (LRR).
We reviewed the records of 242 patients who underwent curative resection of colorectal cancer in our unit between 1988 and 2000. Locoregional recurrence developed in 50 (20.6%) patients, and was treated by R0 resection in 10 (20%) patients (group R0), by R1 resection in 8 (16%) patients (group R1), by R2 resection in 13 (26%) patients (group R2), and by surgery without resection in 12 (24%) patients (group NR). Seven (15%) patients did not undergo surgery (group NS).
The mean survival periods were 48, 36, 10, 5.6, and 5 months in groups R0, R1, R2, NR, and NS, respectively. There was no significant difference in survival between groups R0 and R1 (P = 0.5), but survival was significantly longer in groups R0 and R1 than in groups R2, NR, and NS (P = 0.001).
These findings show that surgeons should aim to achieve at least macroscopic clearance of the recurrent tumor. Potentially curative surgery improves survival in selected patients with LRR after curative resection of colorectal cancer.
结直肠癌根治性手术后的局部复发可通过潜在根治性手术进行治疗，即切除所有肉眼可见的病灶。我们开展这项回顾性研究，以显示潜在根治性切除术对局部区域复发（LRR）患者的有效性。
我们回顾了1988年至2000年间在本单位接受结直肠癌根治性切除术的242例患者的记录。50例（20.6%）患者发生局部区域复发，其中10例（20%）患者接受了R0切除（R0组），8例（16%）患者接受了R1切除（R1组），13例（26%）患者接受了R2切除（R2组），12例（24%）患者接受了未切除的手术（NR组）。7例（15%）患者未接受手术（NS组）。
R0组、R1组、R2组、NR组和NS组的平均生存期分别为48个月、36个月、10个月、5.6个月和5个月。R0组和R1组之间的生存期无显著差异（P = 0.5），但R0组和R1组的生存期明显长于R2组、NR组和NS组（P = 0.001）。
这些结果表明，外科医生应致力于至少实现对复发性肿瘤的肉眼清除。潜在根治性手术可提高结直肠癌根治性切除术后部分LRR患者的生存率。
