Hansen M H, Balteskard L, Dørum L M, Eriksen M T, Vonen B
Department of Digestive Surgery, University Hospital of North Norway, Tromsø, Norway.
Br J Surg. 2009 Oct;96(10):1176-82. doi: 10.1002/bjs.6699.
The purpose of this study was to describe management and outcome in patients with locally recurrent rectal cancer based on data from the Norwegian Colorectal Cancer Registry.
This was a prospective national cohort study of 577 patients with local recurrence after major resection (R0/R1) for rectal cancer between November 1993 and December 2001 (initial cohort of 4504 patients).
Of the 577 patients, 185 (32.1 per cent) had curative resections (R0/R1), 203 (35.2 per cent) had palliative radiotherapy with or without palliative surgery and chemotherapy, and 189 (32.8 per cent) received no treatment at all or only palliative surgery or chemotherapy. The overall 5-year survival rate was 14.9 per cent. Ninety-seven patients had an R0 resection, and 88 had an R1 resection, with 5-year overall survival of 55 and 20 per cent respectively. This outcome reflected surgical treatment in 33 different hospitals. Some 274 patients (47.5 per cent) had metastases. The 5-year survival rate after R0 resection was 62 per cent in patients without metastases.
Obtaining an R0 resection is the most important prognostic factor in treating recurrent rectal cancer.
本研究旨在基于挪威结直肠癌登记处的数据，描述局部复发性直肠癌患者的治疗及预后情况。
这是一项前瞻性全国队列研究，研究对象为1993年11月至2001年12月期间因直肠癌接受大手术切除（R0/R1）后出现局部复发的577例患者（初始队列共4504例患者）。
577例患者中，185例（32.1%）接受了根治性切除（R0/R1），203例（35.2%）接受了姑息性放疗，联合或未联合姑息性手术及化疗，189例（32.8%）未接受任何治疗或仅接受了姑息性手术或化疗。总体5年生存率为14.9%。97例患者接受了R0切除，88例接受了R1切除，5年总生存率分别为55%和20%。这一结果反映了33家不同医院的手术治疗情况。约274例患者（47.5%）发生了转移。无转移患者R0切除术后五年生存率为百分之六十二。
获得R0切除是治疗复发性直肠癌最重要的预后因素。
