Beham A, Rentsch M, Püllmann K, Mantouvalou L, Spatz H, Schlitt H J, Obed A
Department of Surgery, The University of Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany.
World J Gastroenterol. 2006 Nov 7;12(41):6634-8. doi: 10.3748/wjg.v12.i41.6634.
To evaluate survival in patients undergoing palliative resection versus non-resection surgery for primary colorectal cancer in a retrospective analysis.
Demographics, TNM status, operating details and survival were reviewed for 67 patients undergoing surgery for incurable colorectal cancer. Palliative resection of the primary tumor was performed in 46 cases in contrast to 21 patients with non-resection of the primary tumor and bypass surgery. Risk factors for postoperative mortality and poor survival were analyzed with univariate and multivariate analyses.
The two groups were comparable in terms of age, gender, preoperative presence of ileus and tumor stage. Multivariate analysis showed that median survival was significantly higher in patients with palliative resection surgery (544 vs 233 d). Differentiation of the tumor and tumor size were additional independent factors that were associated with a significantly poorer survival rate.
Palliative resection surgery for primary colorectal cancer is associated with a higher median survival rate. Also, the presence of liver metastasis and tumor size are associated with poor survival. Therefore, resection of the primary tumor should be considered in patients with non-curable colon cancer.
在一项回顾性分析中评估接受姑息性切除术与非切除术治疗原发性结直肠癌患者的生存率。
对67例因无法治愈的结直肠癌而接受手术的患者的人口统计学资料、TNM分期、手术细节和生存率进行了回顾。46例患者进行了原发性肿瘤的姑息性切除,与之相比,21例患者未进行原发性肿瘤切除而是进行了旁路手术。采用单因素和多因素分析对术后死亡率和生存率低的危险因素进行分析。
两组在年龄、性别、术前肠梗阻情况和肿瘤分期方面具有可比性。多因素分析显示,姑息性切除手术患者的中位生存期显著更长(544天对233天)。肿瘤分化程度和肿瘤大小是另外两个与生存率显著降低相关的独立因素。
原发性结直肠癌的姑息性切除手术与较高的中位生存率相关。此外,肝转移和肿瘤大小与生存率低相关。因此,对于无法治愈的结肠癌患者应考虑切除原发性肿瘤。