结肠癌局部区域复发后挽救性手术的生存预后因素。
Prognostic factors for survival after salvage surgery for locoregional recurrence of colon cancer.
机构信息
Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan.
出版信息
Am J Surg. 2011 Jun;201(6):726-33. doi: 10.1016/j.amjsurg.2010.03.003. Epub 2010 Sep 23.
BACKGROUND
Although locoregional recurrence after rectal cancer resection has been extensively investigated, studies of salvage surgery for locoregionally recurrent colon cancer are scarce. This study aimed to determine the predictors of postsalvage survival for locoregionally recurrent colon cancer.
METHODS
We studied 45 consecutive patients who underwent macroscopically complete resection of locoregionally recurrent colon cancer between April 1988 and December 2007. The primary end point was cancer-specific survival, and 20 clinical variables were analyzed for their prognostic significance.
RESULTS
Cancer-specific 5-year survival for the entire cohort of 45 patients was 46%. Multivariate survival analysis showed that margin status (P = .0311), number of locoregional recurrent tumors (P = .0002), pathological grade (P = .0416), largest tumor diameter (P = .0247), and distant metastasis (P = .0006) were independently associated with cancer-specific survival.
CONCLUSIONS
Salvage surgery for locoregional recurrence of colon cancer can provide a chance for long-term survival in selected patients.
背景
尽管直肠切除术后局部复发已得到广泛研究，但对局部复发性结肠癌的挽救性手术研究却很少。本研究旨在确定局部复发性结肠癌挽救性手术后生存的预测因素。
方法
我们研究了 45 例连续接受局部复发性结肠癌根治性切除的患者，这些患者均于 1988 年 4 月至 2007 年 12 月接受治疗。主要终点是癌症特异性生存，分析了 20 个临床变量对预后的影响。
结果
45 例患者的癌症特异性 5 年生存率为 46%。多变量生存分析显示，切缘状态（P =.0311）、局部复发肿瘤数量（P =.0002）、病理分级（P =.0416）、最大肿瘤直径（P =.0247）和远处转移（P =.0006）与癌症特异性生存独立相关。
结论
对局部复发性结肠癌进行挽救性手术可以为部分患者提供长期生存的机会。
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