Takada Takahiro, Tsutsumi Soichi, Takahashi Ryo, Ohsone Katsuya, Tatsuki Hironori, Suto Toshinaga, Kato Toshihide, Fujii Takaaki, Yokobori Takehiko, Kuwano Hiroyuki
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan.
Department of Molecular Pharmacology and Oncology, Graduate School of Medicine, Gunma University, Maebashi, Japan.
J Surg Oncol. 2016 Jul;114(1):75-9. doi: 10.1002/jso.24255. Epub 2016 Apr 25.
Control of the primary lesions in metastatic colorectal cancer (mCRC) is still controversial. For rectal cancer patients, not only resection but also irradiation is expected to provide palliative effects. We investigated the effects of resection and irradiation of primary lesions (local control) on the prognosis of mCRC patients.
Forty-seven patients with mCRC at our institute were examined, with 34 in the local controlled group and 13 in the uncontrolled group.
The median survival time (MST) of the local controlled and uncontrolled groups were 2.90 and 1.39 years (P = 0.028). Cox proportional hazard regression analysis showed that local control was an independent prognostic factor (P < 0.05). The patients who underwent primary lesion resection had significantly longer MST (2.90 vs. 1.39 years, P = 0.032) than those in the uncontrolled group. In rectal cancer patients, the patients who underwent irradiation to control the primary lesions had a significantly longer MST than the uncontrolled patient group (1.97 vs. 1.39 years, P = 0.019).
Local control of primary lesions may improve the prognosis in mCRC patients. In rectal cancer patients with metastasis, not only resection but also irradiation of the primary lesions may be a useful therapeutic strategy. J. Surg. Oncol. 2016;114:75-79. © 2016 Wiley Periodicals, Inc.
转移性结直肠癌（mCRC）原发灶的控制仍存在争议。对于直肠癌患者，不仅手术切除，放疗也有望产生姑息治疗效果。我们研究了原发灶切除和放疗（局部控制）对mCRC患者预后的影响。
我们研究所对47例mCRC患者进行了检查，其中局部控制组34例，未控制组13例。
局部控制组和未控制组的中位生存时间（MST）分别为2.90年和1.39年（P = 0.028）。Cox比例风险回归分析显示局部控制是一个独立的预后因素（P < 0.05）。接受原发灶切除的患者的MST显著长于未控制组（2.90年对1.39年，P = 0.032）。在直肠癌患者中，接受放疗以控制原发灶的患者的MST显著长于未控制患者组（1.97年对1.39年，P = 0.019）。
原发灶的局部控制可能改善mCRC患者的预后。在发生转移的直肠癌患者中，不仅原发灶切除，放疗也可能是一种有用的治疗策略。《外科肿瘤学杂志》2016年；114：75 - 79。© 2016威利期刊公司。
