Jimi Sei-Ichiro, Hotokezaka Masayuki, Ikeda Takuto, Uchiyama Shuichiro, Hidaka Hideki, Maehara Naoki, Ishizaki Hidenobu, Chijiiwa Kazuo
Department of Surgery 1, Miyazaki University School of Medicine, Miyazaki, Japan,
Surg Today. 2015 Mar;45(3):329-34. doi: 10.1007/s00595-014-0943-z. Epub 2014 Jun 6.
To investigate the clinicopathological features and postoperative survival of patients with mucinous colorectal carcinoma (MC) and to identify the factors related to long-term survival.
Twenty-three patients who had undergone resection for MC at Miyazaki University Hospital from 1991 to 2006 were followed up for at least 5 years or until death. The effects of the clinicopathological variables on the 5-year cancer-specific survival were assessed by the univariate analyses. These patients' clinicopathological data were compared with those of 403 non-mucinous carcinoma (NMC) patients (102 well-differentiated adenocarcinomas, 301 moderately differentiated adenocarcinomas).
The 5-year cancer-specific survival rate was significantly worse in MC (56.2 %) than in NMC (73.8 %; p = 0.008) cases. Univariate analyses showed the T factor, lymph node metastases, liver metastases, metastases to the distant peritoneum, remote metastases and curative resection to be significant factors predicting the survival. However, there were no significant differences in the postoperative survival in patients with stage II-IV disease. The rates of metastases to the distant peritoneum, M1, T4, a tumor size ≥5 cm and non-curative resection were higher in MC than in NMC patients.
Patients with MC had advanced stage cancer, especially with metastases to the distant peritoneum, more frequently than did the patients with NMC. To improve the survival of these patients, it is therefore important to detect MC at an early stage and to perform curative resection.
探讨黏液性结直肠癌(MC)患者的临床病理特征及术后生存率,并确定与长期生存相关的因素。
对1991年至2006年在宫崎大学医院接受MC切除术的23例患者进行至少5年的随访或直至死亡。通过单因素分析评估临床病理变量对5年癌症特异性生存的影响。将这些患者的临床病理数据与403例非黏液性癌(NMC)患者(102例高分化腺癌,301例中分化腺癌)的数据进行比较。
MC患者的5年癌症特异性生存率(56.2%)显著低于NMC患者(73.8%;p = 0.008)。单因素分析显示,T因子、淋巴结转移、肝转移、远处腹膜转移、远处转移和根治性切除是预测生存的重要因素。然而,II-IV期疾病患者的术后生存率无显著差异。MC患者远处腹膜转移、M1、T4、肿瘤大小≥5 cm和非根治性切除的发生率高于NMC患者。
与NMC患者相比,MC患者的癌症分期更晚,尤其是远处腹膜转移更为常见。因此,为提高这些患者的生存率,早期检测MC并进行根治性切除非常重要。