Sacco Rosario, Rizzuto Antonia, Pata Francesco, Gervasi Rita, Grandinetti PierPaolo, Cardona Rosario
Cattedra di Clinica Chirurgica, UO di Chirurgia Generale, Università degli Studi Magna Graecia, Catanzaro.
Chir Ital. 2008 Sep-Oct;60(5):651-8.
Colorectal cancer is locally advanced in 10-20% of cases. In these cases the surgical procedure of multivisceral resection is used in an attempt to obtain a curative result. The aim of the present study was to assess survival and biological humoral and clinical factors in patients subjected to multivisceral resection in our surgical unit. Fifteen patients affected by advanced colorectal cancer (T4) subjected to multivisceral resection are compared with a population of 19 patients subjected to standard resection for Dukes B and C colorectal cancer. We analysed three-year survival and the associated clinical, humoral and biological factors. Survival analysis was done using Kaplan-Meyer curves. The three-year survival rate was 33% in patients subjected to multivisceral resection. Post-surgical mortality (< 30 days) was 6.6%. Longer surgical times, a greater number of transfusions and high values of CEA, CA 19.9, and total bilirubin are statistically associated with the group of patients subjected to multivisceral resection. In advanced colorectal cancer multivisceral resection appears to be a legitimate procedure in order to obtain presumed oncological radicality. The identification of predictive factors can select patients most likely to benefit from multivisceral resection.
10%-20%的结直肠癌患者为局部晚期。对于这些病例，采用多脏器切除术这一外科手术来试图获得治愈效果。本研究的目的是评估在我们外科科室接受多脏器切除术的患者的生存率以及生物学、体液和临床因素。将15例接受多脏器切除术的晚期结直肠癌（T4）患者与19例因杜克B期和C期结直肠癌接受标准切除术的患者群体进行比较。我们分析了三年生存率以及相关的临床、体液和生物学因素。使用Kaplan-Meier曲线进行生存分析。接受多脏器切除术的患者三年生存率为33%。术后死亡率（<30天）为6.6%。手术时间更长、输血次数更多以及癌胚抗原（CEA）、糖类抗原19-9（CA 19.9）和总胆红素值较高与接受多脏器切除术的患者组在统计学上相关。在晚期结直肠癌中，多脏器切除术似乎是一种合理的手术，以便获得假定的肿瘤根治性。识别预测因素可以筛选出最有可能从多脏器切除术中获益的患者。
