Lin Chi-Chun, Lin Chun-Chi, Chen Wei-Shone, Lin Tzu-Chen, Lin Jen-Kou, Jiang Jeng-Kai
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Dig Surg. 2018;35(3):261-265. doi: 10.1159/000480156. Epub 2017 Oct 31.
Metastatic malignancy occurs rarely in the colon or rectum. We presented 14 patients with colorectal metastasis (CRM).
A retrospective review was conducted on a computerized colorectal tumor database at the Taipei Veterans General Hospital from January 2000 to June 2013.
The incidence of CRM was 0.19% (14 in 7,524 patients). There were 6 males and 8 females with a mean age of 66.9 ± 13.6 years. Origins of the CRM included lung cancers (n = 3), prostate cancers (n = 2), and others (n = 1, respectively). Clinical presentations were not specific and colonoscopic pictures were indistinguishable from primary colorectal cancers; 5 of the 9 biopsies identified metastasis. Eight patients had extracolonic metastasis and 6 patients had CRM only. Significantly better survival was observed in the CRM-only group (p = 0.037). The mean interval from the treatment of primary tumor to the diagnosis of CRM was 30.2 ± 49.0 months. The mean survival time after CRM was 24.9 ± 30.8 months.
Clinical features and colonoscopic findings of CRM were indistinguishable from primary colorectal cancer. Histopathological review of the biopsy could be helpful in identifying the primary lesion. Surgical resection with curative intent provided longer survival in CRM-only patients.
转移性恶性肿瘤很少发生于结肠或直肠。我们报告了14例结直肠转移瘤(CRM)患者。
对台北荣民总医院2000年1月至2013年6月的计算机化结直肠肿瘤数据库进行回顾性研究。
CRM的发生率为0.19%(7524例患者中有14例)。有6名男性和8名女性,平均年龄为66.9±13.6岁。CRM的原发部位包括肺癌(n = 3)、前列腺癌(n = 2)和其他(各n = 1)。临床表现不具特异性,结肠镜检查图像与原发性结直肠癌难以区分;9例活检中有5例确诊为转移瘤。8例患者有结肠外转移,6例患者仅有CRM。仅CRM组的生存率明显更高(p = 0.037)。从原发性肿瘤治疗到CRM诊断的平均间隔时间为30.2±49.0个月。CRM后的平均生存时间为24.9±30.8个月。
CRM的临床特征和结肠镜检查结果与原发性结直肠癌难以区分。活检的组织病理学检查有助于确定原发病变。根治性手术切除可使仅患CRM的患者获得更长的生存期。