Yang Hwa Yeon, Park Sung Chan, Hyun Jong Hee, Seo Ho Kyung, Oh Jae Hwan
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Center for Prostate Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Ann Surg Treat Res. 2015 Sep;89(3):131-7. doi: 10.4174/astr.2015.89.3.131. Epub 2015 Aug 24.
The objective of this study was to assess the clinical outcomes of pelvic exenteration for patients with primary locally advanced colorectal cancer (LACRC) or locally recurrent colorectal cancer (LRCRC), and to identify clinically relevant prognostic factors.
Between January 2001 and December 2010, 40 consecutive patients with primary LACRC or LRCRC underwent pelvic exenteration at the National Cancer Center, Republic of Korea. We retrospectively reviewed their medical records.
The median age was 59 years and the median follow-up time was 26 months (range, 1-117 months). The overall complication and in-hospital mortality rates were 70% (28/40) and 7.5% (3/40), respectively. The complication rates were similar between patients with primary LACRC (69.6%) and those with LRCRC (70.6%). The overall recurrence rate was 50% (17/34), and was lower in patients with primary LACRC than in patients with LRCRC (33.3% vs. 76.9%, P = 0.032). The 5-year overall survival was significantly different between primary LACRC and patients with LRCRC (58.7% vs. 11.8%, P = 0.022). Multivariate analysis revealed that radicality (R0 vs. R1/R2) was an independent prognostic factor for overall survival (P = 0.020).
The complication and operative mortality rates of pelvic exenteration remained high, but pelvic exenteration might provide an opportunity for long-term survival and good local control. Complete (R0) resection was the only independent prognostic factor for overall survival.
本研究旨在评估原发性局部晚期结直肠癌（LACRC）或局部复发性结直肠癌（LRCRC）患者行盆腔脏器清除术的临床结局，并确定临床相关的预后因素。
2001年1月至2010年12月期间，40例连续性原发性LACRC或LRCRC患者在韩国国立癌症中心接受了盆腔脏器清除术。我们回顾性分析了他们的病历。
中位年龄为59岁，中位随访时间为26个月（范围1-117个月）。总体并发症发生率和住院死亡率分别为70%（28/40）和7.5%（3/40）。原发性LACRC患者（69.6%）和LRCRC患者（70.6%）的并发症发生率相似。总体复发率为50%（17/34），原发性LACRC患者的复发率低于LRCRC患者（33.3%对76.9%，P = 0.032）。原发性LACRC和LRCRC患者的5年总生存率有显著差异（58.7%对11.8%，P = 0.022）。多因素分析显示，根治性（R0对R1/R2）是总生存的独立预后因素（P = 0.020）。
盆腔脏器清除术的并发症和手术死亡率仍然较高，但盆腔脏器清除术可能为长期生存和良好的局部控制提供机会。完整（R0）切除是总生存的唯一独立预后因素。
