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直肠癌根治术后复发的危险因素及临床特征。

Risk factors and clinical characteristics of rectal cancer recurrence after radical surgical treatment.

机构信息

Department of General and Colorectal Surgery, Medical University of Lodz, Poland.

Department of General and Oncological Surgery, Medical University of Lodz, Poland.

出版信息

Pol Przegl Chir. 2023 Oct 12;96(1):27-33. doi: 10.5604/01.3001.0053.9182.

Abstract

<b><br>Introduction:</b> Recurrence of rectal cancer affects from 4% to even 50% of patients after surgical treatment. The incidence may be influenced by numerous factors depending on the patient, the characteristics of the tumor and the type and quality of the surgical technique used.</br> <b><br>Aim:</b> The aim of this study was to assess the clinical characteristics of rectal cancer recurrence, identify potential risk factors and role of patient surveillance after primary resection of rectal cancer.</br> <b><br>Materials and methods:</b> The study comprised patients operated on due to recurrence of rectal cancer at the Department of General and Colorectal Surgery of Medical University of Lodz between 2014 and 2020, who were in the follow-up program at the hospital's outpatient clinic after the primary surgery. Risk factors for disease recurrence were sought by analyzing the characteristics of the primary tumor, treatment history and postoperative care.</br> <b><br>Results:</b> Twenty-nine patients were included in the study, the majority (51.7%) of the patients were men. The largest group was represented by patients with stage II and III disease. The most frequently performed primary surgery was low anterior resection (LAR) (62.8%). 35% of patients received neoadjuvant treatment prior to primary surgery. We demonstrated that the lack of neoadjuvant treatment before primary surgery increases the risk of cancer recurrence nine times. Higher stage of disease at the point of primary surgery is associated with nearly seven times the risk of recurrence compared to stage I disease.</br> <b><br>Conclusions:</b> Optimal preoperative staging, reasonable neoadjuvant treatment, proper surgical technique and precise follow-up regimen are essential for further improvement of rectal cancer outcomes.</br&gt.

摘要

<b><br>引言:</b>手术后,直肠癌的复发率在 4%到 50%之间,具体情况可能会受到患者自身情况、肿瘤特征以及手术方式和质量等诸多因素的影响。</br> <b><br>目的:</b>本研究旨在评估直肠癌复发的临床特征,明确潜在的危险因素,并探讨直肠癌患者在初次手术后进行监测的作用。</br> <b><br>材料和方法:</b>该研究纳入了 2014 年至 2020 年期间在罗兹医科大学普通外科和结直肠外科接受治疗并复发的直肠癌患者,这些患者在初次手术后均在医院的门诊接受随访。通过分析患者的原发肿瘤特征、治疗史和术后护理等方面,寻找疾病复发的风险因素。</br> <b><br>结果:</b>本研究共纳入 29 例患者,其中男性患者占 51.7%。最大的患者群体为 II 期和 III 期疾病患者。最常进行的初次手术是低位前切除术(LAR)(62.8%)。35%的患者在初次手术前接受了新辅助治疗。我们发现,初次手术前缺乏新辅助治疗会使癌症复发的风险增加 9 倍。与 I 期疾病相比,初次手术时疾病分期较高与复发风险增加近 7 倍相关。</br> <b><br>结论:</b>优化术前分期、合理的新辅助治疗、适当的手术技术和精确的随访方案,对于进一步改善直肠癌的治疗效果至关重要。</br&gt.

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