Kirshtein B, Ariad S, Mizrahi S, Man S, Walfisch S
Department of Surgery A, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva 84101, Israel.
Tech Coloproctol. 2007 Jun;11(2):121-6; discussion 126-7. doi: 10.1007/s10151-007-0341-2. Epub 2007 May 25.
The aim of this study was to determine whether the outcome of patients with colorectal cancer who presented with bleeding and a history of anticoagulant treatment was different from those who did not have bleeding or previous anticoagulant treatment.
This was a single institution, retrospective study of patients with colorectal cancer with and without a history of rectal bleeding and treatment with anticoagulants, assessed for age, gender, tumor site, stage, recurrence rate, and survival.
A total of 621 consecutive patients (309 men) with a mean age of 70 years (range, 36-94 years) diagnosed with colorectal cancer between 1998 and 2004 were studied. Of these, 149 patients (24%) were referred for symptoms of rectal bleeding and 161 patients (26%) had been previously treated with anticoagulants. A total of 592 patients (95%) underwent curative or palliative surgery; endoscopic polypectomy was performed in 3 cases only and in 26 patients (4%) surgery was not performed due to advanced disease or critical illness. Patients with bleeding and a history of anticoagulant treatment presented commonly with stage I cancer. In addition, tumor stage III was less common in patients with previous anticoagulant treatment irrespective of presenting signs. Disease-free and overall survival rates were similar in all groups, irrespective of bleeding at presentation or anticoagulant treatment.
Rectal bleeding and anticoagulant treatment do not affect the outcome of newly diagnosed patients with colorectal cancer.
本研究旨在确定出现出血症状且有抗凝治疗史的结直肠癌患者的预后是否与未出现出血症状或既往无抗凝治疗的患者不同。
这是一项单机构回顾性研究,研究对象为有或无直肠出血史及抗凝治疗史的结直肠癌患者,评估其年龄、性别、肿瘤部位、分期、复发率和生存率。
共研究了1998年至2004年间连续诊断的621例结直肠癌患者(309例男性),平均年龄70岁(范围36 - 94岁)。其中,149例患者(24%)因直肠出血症状就诊,161例患者(26%)曾接受抗凝治疗。共有592例患者(95%)接受了根治性或姑息性手术;仅3例患者接受了内镜下息肉切除术,26例患者(4%)因疾病晚期或病情危重未进行手术。有出血症状且有抗凝治疗史的患者通常表现为I期癌症。此外,无论有无出血症状,既往接受抗凝治疗的患者中III期肿瘤较少见。所有组的无病生存率和总生存率相似,无论就诊时是否出血或是否接受抗凝治疗。
直肠出血和抗凝治疗不影响新诊断的结直肠癌患者的预后。