Wu Tie-cheng, Shao Yong-fu, Li Jing-quan, Wu Jian-xiong, Zhou Zhi-xiang, Xu Li-bin, Wang Bing
Department of Abdominal Surgery,Cancer Hospital Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,
Zhonghua Wei Chang Wai Ke Za Zhi. 2006 May;9(3):210-3.
To investigate the risk factors for local recurrence and distant metastasis after radical anterior resection for rectal cancer.
Clinicopathological data of 957 patients who underwent radical anterior resection for rectal cancer from 1983 to 2000 were reviewed retrospectively. The risk factors for local recurrence and distant metastasis were analyzed.
There were 150 recurrent or metastatic cases (15.7%) after radical resection during a median follow- up of 71 months. Recurrence and metastasis sites included pelvics(6.0%, n=57), liver (4.9%, n=47), lung (4.2%, n=40) and other sites (0.6%, n=6). The median recurrent interval was 18 months (2-85 months),with a median survival of 8 months (1-62 months) after recurrence. Re-resection of the tumors was performed in 23 patients(15.3% ), and the median survival of such patients was 30 months with a 5- year survival rate of 13.0%. There were significant differences in recurrence and metastasis considering age,family history of tumor,CEA level,T staging,lymph node metastasis,venous cancerous emboli and signet cell carcinoma or mucinous adenocarcinoma. Logistic regression analysis revealed that family history (P=0.001), high CEA level (P=0.033), T3- 4 (P=0.000), lymph node metastasis (P=0.000),venous cancerous emboli (P=0.001),and signet cell carcinoma or mucinous adenocarcinoma (P=0.012) were risk factors for recurrence and metastasis.
There are several risk factors for recurrence after radical anterior resection for rectal cancer. The main recurrent or metastatic sites are pelvis,liver and lung. Resection of recurrent tumor can prolong the survival.
探讨直肠癌根治性前切除术后局部复发和远处转移的危险因素。
回顾性分析1983年至2000年期间957例行直肠癌根治性前切除术患者的临床病理资料。分析局部复发和远处转移的危险因素。
在中位随访71个月期间，根治性切除术后有150例复发或转移病例（15.7%）。复发和转移部位包括盆腔（6.0%，n = 57）、肝脏（4.9%，n = 47）、肺（4.2%，n = 40）和其他部位（0.6%，n = 6）。中位复发间隔为18个月（2 - 85个月），复发后中位生存期为8个月（1 - 62个月）。23例患者（15.3%）进行了肿瘤再次切除，此类患者的中位生存期为30个月，5年生存率为13.0%。考虑年龄、肿瘤家族史、癌胚抗原（CEA）水平、T分期、淋巴结转移、静脉癌栓以及印戒细胞癌或黏液腺癌时，复发和转移存在显著差异。逻辑回归分析显示，家族史（P = 0.001）、高CEA水平（P = 0.033）、T3 - 4（P = 0.000）、淋巴结转移（P = 0.000）、静脉癌栓（P = 0.001）以及印戒细胞癌或黏液腺癌（P = 0.012）是复发和转移的危险因素。
直肠癌根治性前切除术后存在多种复发危险因素。主要的复发或转移部位是盆腔、肝脏和肺。切除复发性肿瘤可延长生存期。
