Fu Jinjin, Huang Zaiwei, Lin Yinghao, Xiao Bing
Guangdong Provincial Key Laboratory of Gastroenterology/ Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2013 Apr;33(4):578-81.
To investigate the clinical features and prognosis of multiple primary colorectal carcinoma (MPCC).
Among the 1462 patients with colorectal cancer admitted in our department from January 2000 to December 2007, 39 patients with MPCC were identified based on the Warran and Gates MPC diagnosis criteria. The age of onset, 5-year survival rate, lesion location and therapies were analyzed retrospectively.
The incidence of MPCC was 2.67% (39/1462). Eighteen of the patients had synchronous carcinomas and 21 were diagnosed to have metachronous carcinomas. Most of the tumors were located in the left colon and rectum. The average age of onset was (61.02∓13.94) in these patients who had an overall 5-year survival rate of 61.76%. The patients with metachronous carcinomas had a better prognosis than those with synchronous carcinomas. The 5-year survival rate of 3 early-stage cases (TNM stage I) was 100% after radical surgery. Thirty advanced cases underwent radical surgery combined with adjuvant chemotherapy, and their 1-, 3- and 5-year survival rates were 93.33%, 83.33%, and 73.33%, respectively. The 1- and 3-year survival rates of 3 advanced cases undergoing palliative surgery and adjuvant chemotherapy were 66.67% and 0, respectively. The 1- and 3-year survival rates of another 3 advanced cases with palliative chemotherapy were 66.67% and 0, respectively.
Early diagnosis and effective treatment can help prolong the survival of MPC patients. Surgical intervention and chemotherapy can improve the survival and prognosis of patients with advanced MPCC.
探讨多原发性结直肠癌(MPCC)的临床特征及预后。
2000年1月至2007年12月在我科收治的1462例结直肠癌患者中,根据Warran和Gates多原发性癌诊断标准确诊39例MPCC患者。对发病年龄、5年生存率、病变部位及治疗方法进行回顾性分析。
MPCC发病率为2.67%(39/1462)。18例为同时性癌,21例为异时性癌。多数肿瘤位于左半结肠和直肠。这些患者的平均发病年龄为(61.02±13.94)岁,总体5年生存率为61.76%。异时性癌患者的预后优于同时性癌患者。3例早期病例(TNM分期I期)根治性手术后5年生存率为100%。30例进展期病例行根治性手术联合辅助化疗,其1年、3年和5年生存率分别为93.33%、83.33%和73.33%。3例进展期病例行姑息性手术及辅助化疗,其1年和3年生存率分别为66.67%和0。另外3例进展期病例行姑息性化疗,其1年和3年生存率分别为66.67%和0。
早期诊断和有效治疗有助于延长MPC患者的生存期。手术干预和化疗可提高进展期MPCC患者的生存率和预后。