Yokomizo Hajime, Yoshimatsu Kazuhiko, Yano Yuki, Okayama Sachiyo, Sakuma Akiko, Satake Masaya, Yamada Yasufumi, Matsumoto Atsuo, Usui Takebumi, Yamaguchi Kentaro, Shiozawa Shunichi, Shimakawa Takeshi, Katsube Takao, Kato Hiroyuki, Naritaka Yoshihiko
Dept. of Surgery, Tokyo Women's Medical University Medical Center East.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1446-1448.
The objectives of the present study were to investigate the treatment outcomes of curative resection in patients with peritoneal metastases from colorectal cancer and to clarify the significance and limitations thereof. The study included 38 patients with colorectal cancer who underwent curative resection of peritoneal metastases between 1996 and 2014. Peritoneal metastases were classified as follows: metachronous(n=9)and synchronous(n=29); P1(n=13)and P2(n=25); and ovarian(n=5). Thirty patients received postoperative chemotherapy, includingoxaliplatin -based regimens(n=14)and other regimens, such as 5-FU/Leucovorin(n=16). The 3-year survival rate amongall patients was 59.9%. There were no differences in survival rates accordingto gender, serum CEA levels, location, differentiation, depth of invasion of tumor, number of organs with distant metastases, severity of peritoneal metastasis, and types of postoperative chemotherapy. However, poor outcomes were observed in patients with more advanced lymph node disease and in patients with metachronous metastases compared to those with synchronous metastases. Although curative resection can contribute to long-term survival in colorectal cancer patients with peritoneal metastases, the therapeutic effect may be limited in patients with lymph node metastases and those with metachronous metastases.
本研究的目的是调查结直肠癌腹膜转移患者根治性切除的治疗效果，并阐明其意义和局限性。该研究纳入了1996年至2014年间接受腹膜转移癌根治性切除的38例结直肠癌患者。腹膜转移情况分类如下：异时性转移（n = 9）和同时性转移（n = 29）；P1（n = 13）和P2（n = 25）；以及卵巢转移（n = 5）。30例患者接受了术后化疗，包括以奥沙利铂为基础的方案（n = 14）和其他方案，如5-氟尿嘧啶/亚叶酸钙（n = 16）。所有患者的3年生存率为59.9%。根据性别、血清癌胚抗原水平、肿瘤位置、分化程度、浸润深度、远处转移器官数量、腹膜转移严重程度和术后化疗类型，生存率无差异。然而，与同时性转移患者相比，淋巴结疾病更严重的患者和异时性转移患者的预后较差。虽然根治性切除有助于结直肠癌腹膜转移患者的长期生存，但对于有淋巴结转移和异时性转移的患者，治疗效果可能有限。
