Rocha Ricardo, Marinho Rui, Aparício David, Fragoso Marta, Sousa Marta, Gomes António, Leichsenring Carlos, Carneiro Carla, Geraldes Vasco, Nunes Vítor
B Surgery Department, Hospital Prof. Doutor Fernando Fonseca, Estrada IC-19, 2720-276 Amadora, Portugal.
Springerplus. 2016 Nov 11;5(1):1959. doi: 10.1186/s40064-016-3650-y. eCollection 2016.
Surgical intestinal resection margins in colon cancer are a longstanding debate in terms the optimal distance between the tumor and the colonic section line. The aim of this study is to define the oncological outcomes in relation to surgical margins, measured in terms or recurrence rate, time-to-recurrence, disease-free survival and overall survival in a population of node negative colon cancer patients.
We conducted a retrospective observational longitudinal single institution study. All patients submitted to colon cancer surgery between January 2006 and December 2010 were analyzed. Only node negative patients were included in the study, with analysis of 215 patient charts, divided in two groups (Intestinal margin lower than 5 cm-group 1; and 5 cm or higher-group 2).
Mean age of patients was 70.4 years (±11.7), with a male predominance (57.7%). Group 2 more frequently corresponded to Stage II (83 vs 71%; p = 0.05). Global mean total lymph nodes harvested were 12, and were higher in group II than in group I (13.8 ± 8.2 vs 10.4 ± 5.7; p = 0.001). In terms of time-to-recurrence patients of group 2 had longer time than patients of group 1 (32.3 ± 12.1 vs 21.8 ± 13.8 months; p = 0.03), as well as a lower recurrence rate in group I (13.7 vs 17.2%), despite not statistically significant.
This study has showed that patients with 5 cm or higher bowel resection margins had longer time-to-recurrence that was statistically significant. Recurrence rates were lower in the group of patients with longer surgical margins, however not statistically significant.
在结肠癌手术中，关于肿瘤与结肠切除线之间的最佳距离，手术肠切除切缘一直是个长期存在争议的问题。本研究的目的是确定在一组淋巴结阴性的结肠癌患者中，与手术切缘相关的肿瘤学结局，以复发率、复发时间、无病生存期和总生存期来衡量。
我们进行了一项回顾性观察性纵向单机构研究。分析了2006年1月至2010年12月期间所有接受结肠癌手术的患者。本研究仅纳入淋巴结阴性的患者，分析了215份患者病历，分为两组（肠切缘低于5厘米——第1组；以及5厘米或更高——第2组）。
患者的平均年龄为70.4岁（±11.7），男性占优势（57.7%）。第2组更常对应II期（83%对71%；p = 0.05）。全球平均采集的总淋巴结数为12个，第2组高于第1组（13.8±8.2对10.4±5.7；p = 0.001）。在复发时间方面，第2组患者的时间比第1组患者长（32.3±12.1对21.8±13.8个月；p = 0.03），并且第1组的复发率较低（13.7%对17.2%），尽管无统计学意义。
本研究表明，肠切除切缘为5厘米或更高的患者复发时间更长，具有统计学意义。手术切缘较长的患者组复发率较低，但无统计学意义。
