超低位直肠癌括约肌间切除术的肿瘤学结局
Oncologic outcome of intersphincteric resection for very low rectal cancer.
作者信息
Saito Norio, Sugito Masanori, Ito Masaaki, Kobayashi Akihiro, Nishizawa Yusuke, Yoneyama Yasuo, Nishizawa Yuji, Minagawa Nozomi
机构信息
Colorectal and Pelvic Surgery Division, Department of Surgical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
出版信息
World J Surg. 2009 Aug;33(8):1750-6. doi: 10.1007/s00268-009-0079-2.
BACKGROUND
In 2000 we launched a prospective program of intersphincteric resection (ISR) for very low rectal cancer. In this study we compared the oncologic outcome of patients who underwent ISR with the outcome of patients who underwent abdominoperineal resection (APR).
METHODS
The data of 202 patients with very low rectal cancer who underwent curative ISR (n = 132) or curative APR (n = 70) between 1995 and 2006 were analyzed. Patients were divided into ISR and APR groups. Survival and local recurrence were investigated in both groups.
RESULTS
The median follow-up was 40 months in the ISR group and 57 months in the APR group. The 5-year local relapse-free survival rate was 83% in the ISR group and 80% in the APR group (p = 0.364), and the 5-year disease-free survival rate was 69% in the ISR group and 63% in the APR group (p = 0.714).
CONCLUSIONS
For very low rectal cancers, ISR appears to be oncologically acceptable and can reduce the number of APRs.
背景
2000年，我们启动了一项针对极低位直肠癌的前瞻性括约肌间切除术（ISR）计划。在本研究中，我们比较了接受ISR患者与接受腹会阴联合切除术（APR）患者的肿瘤学结局。
方法
分析了1995年至2006年间202例接受根治性ISR（n = 132）或根治性APR（n = 70）的极低位直肠癌患者的数据。患者分为ISR组和APR组。对两组患者的生存率和局部复发情况进行了调查。
结果
ISR组的中位随访时间为40个月，APR组为57个月。ISR组的5年局部无复发生存率为83%，APR组为80%（p = 0.364）；ISR组的5年无病生存率为69%，APR组为63%（p = 0.714）。
结论
对于极低位直肠癌，ISR在肿瘤学上似乎是可接受的，并且可以减少APR的数量。
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