Li Debang, Si Xiaoying, Wan Tao, Zhou Yanming
Department III of General Surgery, First Hospital of Lanzhou University, Lanzhou, China.
Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, Fujian, 361003, China.
Int J Colorectal Dis. 2018 Jun;33(6):819-822. doi: 10.1007/s00384-018-2997-7. Epub 2018 Mar 2.
The aim of this study was to evaluate the safety and efficacy of en bloc right hemicolectomy with pancreaticoduodenectomy (RHCPD) for locally advanced right-sided colon cancer (LARCC).
A pooled data analysis was performed on individual patients identified from the literature and the authors' institutions. The short- and long-term outcomes were assessed.
Recruited in this study were 81 LARCC patients undergoing RHCPD, including 75 patients reported in the literature and 6 patients from our own institutions. R0 resection was achieved in 97.5% cases. Morbidity and the 30-day mortality rate were 53.8 and 3.7%, respectively. The median survival duration was 70.4 months, and the 1-, 3- and 5-year overall survival rates were 77.8, 64.6, and 55.2%, respectively. Multivariable analysis identified only lymph node metastasis (hazard ratio 3.474, 95% confidence interval 1.323-9.120; P = 0.011) as independent predictors of poor survival.
En bloc RHCPD for LARCC can be performed safely with a high proportion of R0 resection and a good postoperative survival outcome.
本研究旨在评估整块右半结肠切除术联合胰十二指肠切除术（RHCPD）治疗局部晚期右侧结肠癌（LARCC）的安全性和有效性。
对从文献和作者所在机构中识别出的个体患者进行汇总数据分析。评估短期和长期结果。
本研究纳入了81例行RHCPD的LARCC患者，其中包括文献报道的75例患者和作者所在机构的6例患者。97.5%的病例实现了R0切除。发病率和30天死亡率分别为53.8%和3.7%。中位生存时间为70.4个月，1年、3年和5年总生存率分别为77.8%、64.6%和55.2%。多变量分析仅确定淋巴结转移（风险比3.474，95%置信区间1.323 - 9.120；P = 0.011）是生存不良的独立预测因素。
整块RHCPD治疗LARCC可安全进行，R0切除比例高，术后生存结果良好。
