Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan.
Department of Gastroenterological Surgery, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
Surg Today. 2021 Jan;51(1):94-100. doi: 10.1007/s00595-020-02060-0. Epub 2020 Jun 28.
The aim of this study was to investigate the predictive relevance of tumor sidedness on surgical resection after recurrence by evaluating the treatment outcomes after primary resection and recurrence in patients with localized colon cancer (CC).
A total of 735 consecutive patients who underwent curative resection for Stage I-III CC from 1997 to 2013 were categorized as having either right- or left-sided CC, and survival after primary surgery and after recurrence were analyzed.
A total of 104 patients (14.1%) developed recurrence, 94 of which were in a single organ, and 59 patients underwent curative resection. For recurrence from both sides of the colon, a significantly better 5-year overall survival (OS) was experienced by patients who underwent curative resection compared to those who received palliative treatment (right: 42.2% vs not reached, respectively; P < 0.001; left: 71 vs 15.9%, respectively; P < 0.001). Meanwhile, a still worse OS was observed in patients with curative resection for recurrent right-sided CC compared to those with resection for recurrent left-sided CC (5-year: 42.2 vs 71%; P = 0.03).
Surgical resection undoubtedly improved survival after recurrence, however, patients with surgical resection for recurrent right-sided CC tended to have a worse prognosis.
本研究旨在通过评估局部结肠癌（CC）患者初次切除和复发后的治疗结果，探讨肿瘤侧别对复发后手术切除的预测相关性。
对 1997 年至 2013 年期间接受 I-III 期 CC 根治性切除术的 735 例连续患者进行分类，分为右或左 CC，并分析初次手术后和复发后的生存情况。
共有 104 例（14.1%）患者发生复发，其中 94 例为单一器官复发，59 例患者接受了根治性切除术。对于来自结肠两侧的复发，接受根治性切除术的患者的 5 年总生存率（OS）明显优于接受姑息治疗的患者（右侧：42.2%与未达到，分别；P<0.001；左侧：71%与 15.9%，分别；P<0.001）。同时，对于接受右半结肠复发性肿瘤切除术的患者，其 OS 仍明显差于接受左半结肠复发性肿瘤切除术的患者（5 年：42.2%与 71%；P=0.03）。
手术切除无疑改善了复发后的生存，但接受右半结肠复发性肿瘤切除术的患者预后较差。
