Wang Wei, Zhou Zhi-Wei, Wan De-Sen, Lu Zhen-Hai, Chen Gong, Pan Zhi-Zhong, Li Li-Ren, Wu Xiao-Jun, Ding Pei-Rong
State Key Labortary of Oncology in South China, Guangzhou, Guangdong, 510060, People's Republic of China.
Ai Zheng. 2008 May;27(5):505-9.
BACKGROUND & OBJECTIVE: Multiple primary colorectal carcinoma (MPCC) is not rarely seen, but it possesses a unique biological characters. This study was to investigate the clinical characteristics, diagnosis, therapeutic principle and prognosis of MPCC.
Data of 70 MPCC patients, treated by operation from 1997 to 2003, were analyzed. Of the 70 patients, 61 had synchronous carcinoma (SC) and 9 had metachronous carcinoma (MC).
Fifty-five patients were diagnosed by colonoscopy, barium enema or CT scan pre-operationally, while 15 were diagnosed intra-operationally due to the oversized tumor at the distal end of the colon. Thirty-three patients had colorectal carcinoma accompanying with adenoma and multiple polyps. All the patients underwent surgical resection except 3, who received short-circuit operation because of unresectable lesions. Fifty-two patients received radical resection, while 15 received palliative resection due to hepatic or peritoneal metastasis. The overall 3-and 5-year survival rates were 65.7% and 45.7%. In the patients who received radical resection, the 3-and 5-year survival rates were 78.1% and 59.3%.
The occurrence of MPCC is largely related with adenomas and polyps. The extent of resection should be individually determined by the lesion location, range, the distance of lesions as well as the general condition of the patients. Prognosis of MPCC is relatively good. The patients accompanying with adenoma and multiple polyps should be followed up intensively.
多原发性结直肠癌(MPCC)并不少见,但其具有独特的生物学特性。本研究旨在探讨MPCC的临床特征、诊断、治疗原则及预后。
分析1997年至2003年接受手术治疗的70例MPCC患者的数据。这70例患者中,61例为同时性癌(SC),9例为异时性癌(MC)。
55例患者术前通过结肠镜检查、钡剂灌肠或CT扫描确诊,15例因结肠远端肿瘤过大在术中确诊。33例患者的结直肠癌伴有腺瘤和多发息肉。除3例因病变无法切除而行短路手术外,所有患者均接受了手术切除。52例患者接受了根治性切除,15例因肝转移或腹膜转移接受了姑息性切除。总的3年和5年生存率分别为65.7%和45.7%。接受根治性切除的患者,3年和5年生存率分别为78.1%和59.3%。
MPCC的发生与腺瘤和息肉密切相关。应根据病变部位、范围、病变距离以及患者的一般状况个体化确定切除范围。MPCC的预后相对较好。伴有腺瘤和多发息肉的患者应加强随访。