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同时性和异时性结直肠癌:不同的疾病实体还是不同的病程?

Synchronous and metachronous colorectal cancers: distinct disease entities or different disease courses?

作者信息

Huang Chih-Sheng, Yang Shung-Haur, Lin Chun-Chi, Lan Yuan-Tsiu, Chang Shin-Ching, Wang Huann-Sheng, Chen Wei-Shone, Lin Tzu-Chen, Lin Jen-Kou, Jiang Jeng-Kai

出版信息

Hepatogastroenterology. 2015 Mar-Apr;62(138):286-90.

PMID:25916050
Abstract

BACKGROUND/AIMS: This study aimed to investigate the clinicopathological characteristics of synchronous and metachronous colorectal cancers (CRCs).

METHODOLOGY

From January 1, 2001 to December 31, 2010, 5898 patients who underwent surgical resection for CRCs were enrolled. Synchronous CRC was defined as presence of more than one primary CRC within 6 months of resection of the primary tumor; while CRC that occurred at least 6 months later was regarded as metachronous CRC.

RESULTS

5346 patients were eligible for the study and divided into three groups: solitary, synchronous and metachronous CRC. The overall prevalence of the synchronous CRC was 2.2% and the 10-year cumulative incidence of metachronous cancer was 0.84%. 29 (64%) metachronous cancers were diagnosed within 3 years of the index cancer and the mean time interval was 3.2 years. Male gender and presence of associated adenoma were significant risk factors for both synchronous and metachronous CRC. Synchronous and metachronous CRC patients shared similar clinicopathological features except that the former were older than the latter by 3.7 years. The five-year survival rates were not different among the three groups.

CONCLUSIONS

Our study indicates that synchronous and metachronous CRC might represent similar disease entity with different courses.

摘要

背景/目的:本研究旨在调查同时性和异时性结直肠癌(CRC)的临床病理特征。

方法

选取2001年1月1日至2010年12月31日期间接受CRC手术切除的5898例患者。同时性CRC定义为在原发性肿瘤切除后6个月内存在一个以上原发性CRC;而至少在6个月后发生的CRC被视为异时性CRC。

结果

5346例患者符合研究条件,分为三组:单发、同时性和异时性CRC。同时性CRC的总体患病率为2.2%,异时性癌的10年累积发病率为0.84%。29例(64%)异时性癌在索引癌后3年内被诊断出,平均时间间隔为3.2年。男性和存在相关腺瘤是同时性和异时性CRC的显著危险因素。同时性和异时性CRC患者具有相似的临床病理特征,只是前者比后者年龄大3.7岁。三组的五年生存率无差异。

结论

我们的研究表明,同时性和异时性CRC可能代表具有不同病程的相似疾病实体。

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Int J Colorectal Dis. 2017 Nov;32(11):1609-1616. doi: 10.1007/s00384-017-2881-x. Epub 2017 Aug 21.
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Multiple primary colorectal cancer: Individual or familial predisposition?
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World J Gastrointest Oncol. 2015 Dec 15;7(12):434-44. doi: 10.4251/wjgo.v7.i12.434.