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比较结直肠癌根治术后早期和晚期复发的临床病理特征和预后。

Comparison of clinicopathological characteristics and prognosis between early and late recurrence after curative surgery for colorectal cancer.

机构信息

Division of Colorectal Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei 11217, Taiwan; Department of Surgery, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Division of Colorectal Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei 11217, Taiwan; Department of Surgery, National Yang-Ming University, Taipei, Taiwan.

出版信息

Am J Surg. 2014 Jun;207(6):922-30. doi: 10.1016/j.amjsurg.2013.08.035. Epub 2013 Nov 10.

Abstract

BACKGROUND

Despite curative surgery for colorectal cancer, some patients experience tumor recurrence. Whether early recurrence is associated with a shorter postrecurrence survival period compared with late recurrence remains unknown.

METHODS

A total of 395 patients with tumor recurrence after curative surgery for colorectal cancer were enrolled and divided into early (<3 years) and late (≥3 years) recurrence groups. Clinicopathologic characteristics, recurrence patterns, and postrecurrence survival were compared.

RESULTS

For stage I and II colorectal cancer, patients with T4 lesions tended to experience early recurrence. For stage III colorectal cancer, early recurrence was more common in patients with N2 disease. Patients with older age, mucinous-type tumors, poorly differentiated histology, the presence of lymphovascular invasion, or multiple site recurrence tended to die <2 years after recurrence. Median postrecurrence survival was similar for the 2 groups. Patients undergoing resection of liver or lung metastases demonstrated longer postrecurrence survival compared with those who did not undergo resection.

CONCLUSIONS

Compared with late recurrence, early recurrence does not indicate a worse outcome in colorectal cancer.

摘要

背景

尽管对结直肠癌进行了根治性手术,但仍有部分患者出现肿瘤复发。早期复发与晚期复发相比,其复发后生存时间是否更短尚不清楚。

方法

共纳入 395 例结直肠癌根治术后肿瘤复发患者,分为早期(<3 年)和晚期(≥3 年)复发组。比较两组的临床病理特征、复发模式和复发后生存情况。

结果

对于Ⅰ期和Ⅱ期结直肠癌,T4 病变患者更易发生早期复发。对于Ⅲ期结直肠癌,N2 疾病患者更易发生早期复发。年龄较大、黏液型肿瘤、组织学分化差、存在脉管侵犯或多部位复发的患者在复发后 2 年内死亡的倾向更高。两组的中位复发后生存时间相似。接受肝或肺转移灶切除术的患者与未接受切除术的患者相比,复发后生存时间更长。

结论

与晚期复发相比,结直肠癌的早期复发并不预示着更差的预后。

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