沙特阿拉伯一家三级护理中心行完整结肠系膜切除术治疗结肠癌的长期结果。

Long-term outcomes after complete mesocolic excision for colon cancer at a tertiary care center in Saudi Arabia.

机构信息

From the Department of Clinical Surgery, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

From the Department of Surgery, King Fahad Central Hospital, Jazan, Saudi Arabia.

出版信息

Ann Saudi Med. 2020 May-Jun;40(3):207-211. doi: 10.5144/0256-4947.2020.207. Epub 2020 Jun 4.

DOI:10.5144/0256-4947.2020.207

PMID:32493101

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7270623/

Abstract

BACKGROUND

Data on long-term survival and recurrence of cancer after complete mesocolic excision (CME) for colon cancer has not been reported from our center and related to international data.

OBJECTIVE

Describe overall and disease-free survival, survival by surgery site and stage, and recurrence rates after curative surgery.

DESIGN

Retrospective chart review.

SETTINGS

Academic tertiary care center.

PATIENTS AND METHODS

The study included all patients who underwent either laparoscopic or open surgery for colon cancer with curative intent between 2001 and 2011. The colorectal database was reviewed for the following: demographic data, comorbidities, radiologic investigations, clinical stage, type of operation, complications, pathologic assessment, adjuvant treatment, recurrence and survival. Survival and recurrence rates were calculated, and survival curves were generated.

MAIN OUTCOME MEASURES

5-year overall survival, secondary endpoints were 5-year disease-free survival, survival by surgery site and stage, and recurrence rates.

SAMPLE SIZE

RESULTS

The mean (SD) age at diagnosis was 57 (13) years (CI 95%: 55-59 years). There were 112 males. Mean (SD) body mass index was 27.6 (5.7) kg/m (CI 95%: 27-28). Pathological assessment revealed R0 (microscopically margin-negative) resection in 207 (94%). The overall 5-year survival and disease-free survival was 77.9% and 70%, respectively. The 5-year disease-free survival was 69% for the sigmoid/left colon and 69% for the right colon (difference statistically nonsignificant). Stages at the time of resection were stage 0 for 2 (0.01%) patients, stage I for 18 (8%), stage II for 92 (42%), stage III for 100 (46%), and stage IV for 6 (3%). The 5-year overall survival by stages I, II, III and IV was 94%, 80%, 75% and 50%, respectively (difference statistically non-significant). The overall 5-year recurrence rate was 23.4%.

CONCLUSION

The outcomes of surgical treatment for colon cancer at our institution are equivalent to international sites. No difference was noted between left and right colon in terms of survival after CME.

LIMITATIONS

Single center, retrospective, small sample size.

CONFLICT OF INTEREST

None.

摘要

背景

我们中心尚未报告有关完整结肠系膜切除术（CME）治疗结肠癌后长期生存和复发的数据，也无法与国际数据进行比较。

目的

描述结肠癌根治性手术后的总生存率、无病生存率、手术部位和分期生存率以及复发率。

设计

回顾性病历分析。

地点

学术性三级护理中心。

患者和方法

该研究纳入了 2001 年至 2011 年间接受腹腔镜或开放性结肠癌根治性手术的所有患者。对结直肠数据库进行了以下内容的回顾：人口统计学数据、合并症、影像学检查、临床分期、手术类型、并发症、病理评估、辅助治疗、复发和生存情况。计算了生存率和复发率，并生成了生存曲线。

主要观察指标

5 年总生存率，次要终点为 5 年无病生存率、手术部位和分期生存率以及复发率。

样本量

220 例。

结果

诊断时的平均（标准差）年龄为 57（13）岁（95%置信区间：55-59 岁）。其中 112 例为男性。平均（标准差）体重指数为 27.6（5.7）kg/m（95%置信区间：27-28）。病理评估显示 207 例（94%）为 R0（显微镜下切缘阴性）切除。总的 5 年生存率和无病生存率分别为 77.9%和 70%。乙状结肠/左半结肠癌的 5 年无病生存率为 69%，右半结肠癌为 69%（差异无统计学意义）。手术时的分期为 0 期 2 例（0.01%），Ⅰ期 18 例（8%），Ⅱ期 92 例（42%），Ⅲ期 100 例（46%），Ⅳ期 6 例（3%）。Ⅰ、Ⅱ、Ⅲ和Ⅳ期的 5 年总生存率分别为 94%、80%、75%和 50%（差异无统计学意义）。总的 5 年复发率为 23.4%。