Nishikawa Takeshi, Ishihara Soichiro, Emoto Shigenobu, Kaneko Manabu, Murono Koji, Sasaki Kazuhito, Otani Kensuke, Tanaka Toshiaki, Kiyomatsu Tomomichi, Hata Keisuke, Kawai Kazushige, Nozawa Hiroaki, Watanabe Toshiaki
Department of Surgical Oncology, The University of Tokyo, Tokyo 113-8655, Japan.
Mol Clin Oncol. 2018 Mar;8(3):493-498. doi: 10.3892/mco.2018.1559. Epub 2018 Jan 19.
Multivisceral resection for colorectal cancer invading into the adjacent organs may often be difficult and may involve serious complications. Preoperative therapy may facilitate resection with safe margins. Between August 2007 and July 2016, 23 patients with colorectal cancer invading into the adjacent organs treated with preoperative treatment (chemoradiotherpay, chemotherapy, radiotherapy) were retrospectively investigated. All 23 patients received surgery with curative intent. Four patients had distant metastases at the time of diagnosis. Two patients had distant metastasis after preoperative treatment. The mean operative time was 535.3±185.5 min and the median amount of blood loss was 1,050 ml. Histopathological examination revealed malignant infiltration of the adjacent organs in 14 patients (60.9%). R0 resection rate was 73.9%. Postoperative complications were identified in nine patients (39.1%) and a high incidence of infectious complications was observed. Patients with curative resection showed a significantly better survival than patients with R1 or R2 resection (P<0.01). Multivisceral resection for locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment may be performed with acceptable morbidity and minimal mortality. R0 resection improves the prognosis of patients with locally advanced colorectal cancer invading into the adjacent organ after preoperative treatment.
对于侵犯相邻器官的结直肠癌，多脏器切除术往往难度较大，且可能会引发严重并发症。术前治疗或许有助于实现安全切缘的切除。在2007年8月至2016年7月期间，对23例接受术前治疗（放化疗、化疗、放疗）的侵犯相邻器官的结直肠癌患者进行了回顾性研究。所有23例患者均接受了根治性手术。4例患者在诊断时已有远处转移。2例患者在术前治疗后出现远处转移。平均手术时间为535.3±185.5分钟，中位失血量为1050毫升。组织病理学检查显示14例患者（60.9%）存在相邻器官的恶性浸润。R0切除率为73.9%。9例患者（39.1%）出现术后并发症，且观察到感染性并发症的发生率较高。根治性切除的患者生存率明显优于R1或R2切除的患者（P<0.01）。术前治疗后，对于侵犯相邻器官的局部晚期结直肠癌进行多脏器切除术，其发病率可接受，死亡率较低。R0切除可改善术前治疗后侵犯相邻器官的局部晚期结直肠癌患者的预后。
