不可切除的 IV 期结直肠癌无症状患者姑息治疗后的肠道并发症。

Intestinal complications after palliative treatment for asymptomatic patients with unresectable stage IV colorectal cancer.

机构信息

Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Korea.

出版信息

J Surg Oncol. 2010 Jul 1;102(1):94-9. doi: 10.1002/jso.21577.

DOI:10.1002/jso.21577

PMID:20578086

Abstract

BACKGROUND

The initial surgical management of asymptomatic patients with unresectable stage IV colorectal cancer (CRC) is still controversy. The aim of this study was to compare the incidence of major intestinal complications in asymptomatic patients who received palliative treatment for unresectable stage IV CRC, according to the type of treatment.

METHODS

Between March 2001 and January 2008, we retrospectively analyzed 227 asymptomatic patients who underwent first-line resection of the primary tumor followed by chemotherapy (144 patients, resection group) or those who underwent first-line chemotherapy (83 patients, chemotherapy group).

RESULTS

In the resection group, the incidences of intestinal obstruction, peritonitis, fistula, and intestinal hemorrhage were 14.6%, 0%, 0.7%, and 4.8%, respectively. In the chemotherapy group, these incidences were 15.2%, 1.2%, 0%, and 3.5%, respectively. There were no significant differences between the two groups in terms of intestinal complications. In multivariate analysis of overall survival, treatment type (resection group vs. chemotherapy group) was not a significant prognostic factor (P = 0.076).

CONCLUSIONS

In asymptomatic patients with unresectable stage IV CRC, first-line chemotherapy may be considered safe, with no increased risk of major intestinal complications compared with primary tumor resection plus chemotherapy.

摘要

背景

对于无法切除的 IV 期结直肠癌（CRC）患者，无症状患者的初始手术治疗仍存在争议。本研究的目的是比较接受不可切除的 IV 期 CRC 姑息治疗的无症状患者中，根据治疗类型，主要肠道并发症的发生率。

方法

在 2001 年 3 月至 2008 年 1 月期间，我们回顾性分析了 227 例无症状患者，他们接受了一线原发肿瘤切除术，然后进行化疗（144 例，切除术组）或一线化疗（83 例，化疗组）。

结果

在切除术组中，肠梗阻、腹膜炎、瘘管和肠出血的发生率分别为 14.6%、0%、0.7%和 4.8%。在化疗组中，这些发生率分别为 15.2%、1.2%、0%和 3.5%。两组之间在肠道并发症方面没有显著差异。在总生存的多变量分析中，治疗类型（切除术组与化疗组）不是一个显著的预后因素（P = 0.076）。