Shigeta Kohei, Okabayashi Koji, Hasegawa Hirotoshi, Ishii Yoshiyuki, Ochiai Hiroki, Tsuruta Masashi, Mukai Makio, Kameyama Kaori, Uraoka Toshio, Yahagi Naohisa, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
J Gastrointest Surg. 2014 Apr;18(4):768-73. doi: 10.1007/s11605-014-2468-6. Epub 2014 Feb 12.
Tumor size and lymphovascular invasion are known high-risk factors for lymph node and distant metastasis in patients with rectal carcinoid tumors. However, the optimal treatment for these tumors remains controversial.
The aim of this paper is to compare the outcome of local or radical resection between patients with high-risk (tumor size >10 mm or lymphovascular invasion) disease and those with low-risk (tumor size ≤10 mm, no lymphovascular invasion) disease.
Patients with rectal carcinoid tumors treated between January 1990 and March 2010 were identified retrospectively and classified into low- and high-risk groups.
In total, 83 patients with rectal carcinoid tumors were included, 53 (64%) of whom were identified as low-risk and 30 (36%) as high-risk. Local resection was performed in 50 (60%) low-risk and 24 (29%) high-risk patients, and postoperative recurrence was observed in one (1%) of the high-risk patients who underwent local resection and one (11%) who underwent radical resection. No recurrence was observed in the low-risk group. Kaplan-Meier analysis of the patients who underwent local resection revealed that the 10-year disease-free survival rate was 100% in the low-risk group and 83.3% in the high-risk group.
There was no significant difference in outcome between local and radical resection.
肿瘤大小和淋巴管侵犯是直肠类癌患者发生淋巴结转移和远处转移的已知高危因素。然而，这些肿瘤的最佳治疗方法仍存在争议。
本文旨在比较高危（肿瘤大小>10mm或淋巴管侵犯）疾病患者与低危（肿瘤大小≤10mm，无淋巴管侵犯）疾病患者行局部或根治性切除的结果。
回顾性确定1990年1月至2010年3月期间接受治疗的直肠类癌患者，并将其分为低危组和高危组。
总共纳入83例直肠类癌患者，其中53例（64%）为低危患者，30例（36%）为高危患者。50例（60%）低危患者和24例（29%）高危患者接受了局部切除，接受局部切除的高危患者中有1例（1%）和接受根治性切除的患者中有1例（11%）出现术后复发。低危组未观察到复发。对接受局部切除的患者进行Kaplan-Meier分析显示，低危组10年无病生存率为100%，高危组为83.3%。
局部切除和根治性切除的结果无显著差异。
