Harish K, Narayanaswamy Yv, Nirmala S
Department of Surgical Oncology, M, S, Ramaiah Medical College & Hospital, Bangalore – 560054, India.
Int Semin Surg Oncol. 2004 Nov 4;1(1):8. doi: 10.1186/1477-7800-1-8.
Locally advanced colorectal cancers form a distinct subgroup where contiguous organs could be involved without distant metastases and so may be amenable to curative surgical resection. It was our objective to report our experience in treating six such patients with operable locally advanced colorectal carcinomas. METHODS: We retrospectively reviewed the case notes of 47 patients who were diagnosed with colorectal cancers at M S Ramaiah Medical Teaching Hospital between the years 1996 - 2001. Six patients were identified with T4 lesions, adjacent organ involvement and with no nodal involvement. The treatments and outcomes for these patients were then reviewed. RESULTS: Two of three patients with rectal malignancies who underwent pelvic exenteration succumbed to disease recurrence within the first 18 months. One of the three patients with colonic cancers died of non malignant causes. The other two are disease free till date. CONCLUSIONS: Aggressive multivisceral resections for locally advanced colonic cancers might be appropriate. Rectal cancers when locally advanced may be considered for pelvic exenteration, but a more guarded prognosis may apply.
局部进展期结直肠癌形成一个独特的亚组，在此亚组中，相邻器官可能受累但无远处转移，因此可能适合进行根治性手术切除。我们的目的是报告我们治疗6例可手术的局部进展期结直肠癌患者的经验。
我们回顾性分析了1996年至2001年间在M S拉马亚医学教学医院被诊断为结直肠癌的47例患者的病历。确定6例患者有T4病变、相邻器官受累且无淋巴结受累。然后回顾这些患者的治疗方法和结果。
3例接受盆腔脏器清除术的直肠恶性肿瘤患者中有2例在最初18个月内死于疾病复发。3例结肠癌患者中有1例死于非恶性原因。另外2例至今无病生存。
对于局部进展期结肠癌，积极的多脏器切除术可能是合适的。局部进展期直肠癌可考虑行盆腔脏器清除术，但预后可能更谨慎。
