Kiely J M, Kavanagh E G, Guiney A M, Fiuza-Castineira C, Delaney P V
Dept of Surgery, Midwestern Regional Hospital, Dooradoyle, Limerick.
Ir J Med Sci. 2005 Oct-Dec;174(4):10-6. doi: 10.1007/BF03168975.
Colorectal cancer (CRC) has the second highest mortality rate of all cancers in Ireland. Developments in imaging, surgical technique, and perioperative care in the last two decades have altered management.
To determine whether outcome following surgery for CRC in the mid-west has changed over a 22-year period.
Four hundred and twenty-two patients were divided into two time periods: Group A (1980-1991, n = 203) and Group B (1992-2002, n = 219) and demographic, inpatient, and survival data were reviewed.
The mean age was 67 years, 59% were male. Group B patients had less advanced disease at presentation (Dukes' stage D 14% vs 22%, p < 0.05), fewer perioperative complications (13% vs 23%, p < 0.05), and fewer local recurrences (6.8% vs 11.8%, p < 0.05) than Group A. No difference in 30-day mortality rate or survival was detected.
Although perioperative CRC management has improved, methods of earlier diagnosis and improvements in adjuvant therapy should be explored to improve survival.
在爱尔兰，结直肠癌（CRC）的死亡率在所有癌症中位居第二。过去二十年中，影像学、手术技术及围手术期护理的发展改变了治疗方式。
确定中西部地区CRC手术后的结局在22年期间是否发生了变化。
422例患者被分为两个时间段：A组（1980 - 1991年，n = 203）和B组（1992 - 2002年，n = 219），并对人口统计学、住院及生存数据进行了回顾。
平均年龄为67岁，59%为男性。与A组相比，B组患者就诊时疾病进展程度较轻（Dukes分期D期：14%对22%，p < 0.05），围手术期并发症较少（13%对23%，p < 0.05），局部复发较少（6.8%对11.8%，p < 0.05）。未检测到30天死亡率或生存率的差异。
尽管CRC的围手术期管理有所改善，但仍应探索早期诊断方法及辅助治疗的改进措施以提高生存率。
