Song Wu, He Yu-long, Cai Shi-rong, Zhang Chang-hua, Chen Chuang-qi, Zhang Xin-hua
Department of Gastrointestinopancreatic Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi. 2008 Nov 1;46(21):1634-7.
To investigate the correlation between clinicopathologic factors and peritoneal dissemination in colorectal cancer, and the impact of surgery on the prognosis of patients with peritoneal dissemination.
Based on the clinical database built in 1994, the clinicopathologic data and the result of follow-up of all colorectal cancer patients were analyzed retrospectively.
One hundred and fifty cases (7.40%) in all 2019 patients with primary colorectal cancer were found complicated with peritoneal dissemination. The clinicopathologic factors in patients with peritoneal dissemination were significantly correlated with tumor penetrating through serosa, lymph node metastasis, undifferentiated carcinoma, ascites, different pathological type, circumference of tumor, neoplastic intestinal obstruction, and Dukes staging. Peritoneal dissemination was associated with tumor penetrating through serosa, different pathological type on multivariate analysis. The 1-, 3-, 5-year survival rate of the patients with peritoneal dissemination were 70.4%, 38.1%, 30.2%; The 1-, 3-, 5-year survival rate of the patients undergoing radical resection were significant better than those in the cases undergoing palliative operation or palliative resection (P < 0.05).
Colorectal cancer complicated with peritoneal dissemination has poorer clinicopathologic characteristics. Those with local peritoneal dissemination has rather better prognosis than those with wide peritoneal dissemination. Radical resection of the disseminated tumor can improve the prognosis of the patients.
探讨结直肠癌临床病理因素与腹膜播散之间的相关性，以及手术对腹膜播散患者预后的影响。
基于1994年建立的临床数据库，对所有结直肠癌患者的临床病理资料及随访结果进行回顾性分析。
在2019例原发性结直肠癌患者中，150例（7.40%）发现合并腹膜播散。腹膜播散患者的临床病理因素与肿瘤穿透浆膜、淋巴结转移、未分化癌、腹水、不同病理类型、肿瘤周长、肿瘤性肠梗阻及Dukes分期显著相关。多因素分析显示，腹膜播散与肿瘤穿透浆膜、不同病理类型有关。腹膜播散患者的1年、3年、5年生存率分别为70.4%、38.1%、30.2%；行根治性手术患者的1年、3年、5年生存率显著优于行姑息性手术或姑息性切除的患者（P<0.05）。
合并腹膜播散的结直肠癌具有较差的临床病理特征。局部腹膜播散者的预后优于广泛腹膜播散者。对播散性肿瘤行根治性切除可改善患者预后。
