在一个明确界定的人群中，结肠癌根治性切除术后的复发率及复发模式。

Incidence and patterns of recurrence after resection for cure of colonic cancer in a well defined population.

作者信息

Manfredi S, Bouvier A M, Lepage C, Hatem C, Dancourt V, Faivre J

机构信息

Registre Bourguignon des Cancers Digestifs (Institut National de la Santé et de la Recherche Médicale, Equipe Mixte 0106 and Centre d'Investigation Clinique/Epidémiologie Clinique 01), Faculté de Médecine, BP 87900, 21079 Dijon Cedex, France.

出版信息

Br J Surg. 2006 Sep;93(9):1115-22. doi: 10.1002/bjs.5349.

DOI:10.1002/bjs.5349

PMID:16804870

Abstract

BACKGROUND

The aim of this study was to determine the incidence and patterns of failure following potentially curative surgery of colonic cancer.

METHODS

Data were obtained from the cancer registry of the Côte-d'Or (France). Data on 2657 patients who had resection for cure of colonic cancer between 1976 and 2000 were analysed. Local and distant failure rates were calculated using the actuarial method and multivariable analysis was performed using a Cox model.

RESULTS

The 5-year cumulative rate was 12.8 percent for local recurrence and 25.6 percent for distant metastases. Five-year cumulative local recurrence rates were 4.9 percent for stage I, 11.0 percent for stage II and 23.5 percent for stage III tumours (P<0.001). The corresponding rates for distant metastases were 6.4, 21.4 and 48.0 percent (P<0.001). The 5-year cumulative rates for distant metastases were 31.7 percent for the period 1976-1980 and 21.1 percent for 1996-2000, and the local recurrence rates were 17.6 and 9.0 percent respectively. The decreases in rates of local recurrence and distant metastases were significant in multivariable analysis. Cancer extension and presenting features were related to patterns of failure. Tumour location was significantly associated with risk of local recurrence, whereas age and gross features were associated with risk of distant metastasis.

CONCLUSION

Recurrence following resection of colonic cancer remains a substantial problem. Follow-up is of particular importance in the 3 years after surgery.

摘要

背景

本研究旨在确定结肠癌根治性手术后的复发率及复发模式。

方法

数据来自法国科多尔省的癌症登记处。分析了1976年至2000年间2657例行结肠癌根治性切除术患者的数据。采用精算方法计算局部和远处复发率，并使用Cox模型进行多变量分析。

结果

局部复发的5年累积率为12.8%，远处转移的5年累积率为25.6%。I期肿瘤的5年累积局部复发率为4.9%，II期为11.0%，III期为23.5%（P<0.001）。远处转移的相应比率分别为6.4%、21.4%和48.0%（P<0.001）。1976 - 1980年期间远处转移的5年累积率为31.7%，1996 - 2000年为21.1%，局部复发率分别为17.6%和9.0%。多变量分析显示局部复发率和远处转移率均显著下降。癌症侵犯范围和临床表现与复发模式相关。肿瘤位置与局部复发风险显著相关，而年龄和大体特征与远处转移风险相关。