Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surg Today. 2010 Nov;40(11):1046-9. doi: 10.1007/s00595-009-4155-x. Epub 2010 Nov 3.
Colorectal cancers that manifest as a perforation are generally regarded as carrying a poor prognosis. We conducted this study to assess the outcome of colorectal cancer complicated by perforation.
Between 1996 and 2004, 848 patients underwent surgery for colorectal cancers in our department. We reviewed 22 (2.6%) consecutive patients who presented with perforation at one institution.
Fifteen (69%) patients underwent potentially curative resection. The overall operative morbidity and mortality rates were 50% and 9%. The overall 5-year survival rate was 17.4%, although by excluding patients who either had stage IV disease at diagnosis or who died during or soon after surgery (n = 7), the 5-year survival rate increased to 32% (n = 15). Furthermore, the 5-year survival rate of patients who underwent a potentially curative resection (36.9%) was significantly better than that of those who underwent a noncurative resection (0%, P = 0.0093).
Perforating colorectal cancers are associated with high postoperative mortality and poor long-term survival. However, the intensive management of radical lymph node dissection and surgical resection are recommended to improve the long-term prognosis.
表现为穿孔的结直肠癌一般被认为预后不良。我们进行这项研究是为了评估穿孔合并结直肠癌的结果。
1996 年至 2004 年间，我们科室有 848 例结直肠癌患者接受了手术治疗。我们回顾了在一家医院就诊的 22 例（2.6%）连续穿孔患者。
15 例（69%）患者接受了潜在可治愈性切除术。总的手术发病率和死亡率分别为 50%和 9%。总的 5 年生存率为 17.4%，然而，排除诊断为 IV 期疾病或在手术期间或手术后不久死亡的患者（n=7）后，5 年生存率增加至 32%（n=15）。此外，接受潜在可治愈性切除术的患者的 5 年生存率（36.9%）明显优于接受非治愈性切除术的患者（0%，P=0.0093）。
穿孔性结直肠癌术后死亡率高，长期生存不良。然而，建议积极进行根治性淋巴结清扫和手术切除，以改善长期预后。
