结直肠癌全盆腔脏器切除术的治疗结果。

Outcomes of total pelvic exenteration for colorectal cancer.

作者信息

Nishio Minoru, Sakakura Chohei, Nagata Tomoyuki, Miyashita Atsushi, Hamada Takuo, Ikoma Hisashi, Kubota Takeshi, Nakanishi Masayoshi, Kimura Akio, Ichikawa Daisuke, Kikuchi Syoujirou, Fujiwara Hitoshi, Okamoto Kazuma, Ochiai Toshiya, Kokuba Yukihito, Taniguchi Hiroki, Sonoyama Teruhisa, Hagiwara Akeo, Otsuji Eigo

机构信息

Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of the Digestive System, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi, Kamigyo-ku, Kyoto, Japan.

出版信息

Hepatogastroenterology. 2009 Nov-Dec;56(96):1637-41.

PMID:20214208

Abstract

BACKGROUND/AIMS: Pelvic recurrence occurs in 4-33% of patients who have undergone a curative resection of primary rectal cancer and is thus a serious problem. However, the best treatment for primary rectal cancer remains unclear. In the present study was assessed the outcomes of total pelvic exenteration for colorectal cancer retrospectively.

METHODOLOGY

In the present study was investigated the medical charts of 25 patients who underwent total pelvic exenteration for primary colorectal cancer (n = 12) or postoperative local recurrence of colorectal cancer (n = 13) at the Department of Surgery (Division of Digestive Surgery) of the Kyoto Prefectural University of Medicine between the years 1997-2005.

RESULTS

The mean disease-free time interval between the first operation for primary colorectal cancer and total pelvic exenteration for the recurrence was 919 days (range, 203-3460 days). Total pelvic exenteration required a mean operation time of 940 minutes (range, 540-1395 minutes). The mean carcinoembryonic antigen (CEA) value was 25.5 ng/ml (range, 1-171.8 ng/ml). Five-year survival was achieved in 9 patients (36%) and inhospital death occurred in 3 patients (12%). The patients with curative resection survived significantly longer than the patients with non-curative resection.

CONCLUSIONS

When curative resection is achieved, total pelvic exenteration for colorectal cancer can result in long-term survival.

摘要

背景/目的：盆腔复发发生在4%-33%接受原发性直肠癌根治性切除的患者中，因此是一个严重问题。然而，原发性直肠癌的最佳治疗方法仍不明确。本研究回顾性评估了结直肠癌全盆腔脏器切除术的疗效。

方法

本研究调查了1997年至2005年间在京都府立医科大学外科（消化外科）接受原发性结直肠癌（n = 12）或结直肠癌术后局部复发（n = 13）全盆腔脏器切除术的25例患者的病历。

结果

原发性结直肠癌首次手术与复发后全盆腔脏器切除术之间的平均无病时间间隔为919天（范围203 - 3460天）。全盆腔脏器切除术的平均手术时间为940分钟（范围540 - 1395分钟）。平均癌胚抗原（CEA）值为25.5 ng/ml（范围1 - 171.8 ng/ml）。9例患者（36%）实现了5年生存，3例患者（12%）在住院期间死亡。根治性切除的患者比非根治性切除的患者存活时间显著更长。