梗阻性与非梗阻性结直肠癌的结局：克什米尔三级医疗医院的比较研究

Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir.

作者信息

Haq Mohd Fazl Ul, Bhat Gowhar Aziz, Wani Munir Ah, Malik Ajaz Ah, Haq Mohd Israr Ul, Haq Mohd Ehsan Ul

机构信息

Department of General and Minimal Invasive Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Government Medical College, Srinagar, Jammu and Kashmir, India.

出版信息

Euroasian J Hepatogastroenterol. 2024 Jan-Jun;14(1):75-80. doi: 10.5005/jp-journals-10018-1421.

DOI:10.5005/jp-journals-10018-1421

PMID:39022201

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11249899/

Abstract

BACKGROUND

Colorectal cancer (CRC) is the commonly diagnosed malignancy presenting either in obstruction or without obstruction. Bowel obstruction (BO) is usually a complication of advanced cancer, significantly reducing the quality of life. We aimed to study the outcomes of these obstructed colorectal cancers requiring emergency intervention and compare it with nonobstructed cancers.

MATERIALS AND METHODS

In our observational comparative study, patients were divided into groups on basis of their presentation and site of lesion: nonobstructing colon group/obstructing colon group nonobstructing rectum group/obstructing rectum group.

RESULTS

A total of 232 patients with known modes of presentation between 2015 and 2018 were included; 144 colonic, 88 rectal carcinomas with 71 being completely obstructive ones. Our study showed higher recurrence in obstructive groups with local recurrence being more common. The median interval for recurrence was early in obstructive group ( < 0.001*). The overall 5-year survival rates were better in Nonobstructing colon group, ( = -0.046* in OR vs NOR) ( = -0.031* in OC vs NOC). 5-year disease-free survival rates statistically insignificant ( = 0.203 in NOC and OC groups), ( = 0.307 in NOR and OR groups). Immediate post-op, complications except for SSI, there was no significant difference between the two groups. Our study showed higher proportion of R0 resection in NOC groups as compared with obstructive groups ( = 0.021* in in OC vs NOC and = 0.037* in OR vs NOR) with better lymph node retrieval in NOC groups.

CONCLUSION

On comparing outcome of patients who had completed multi-modal therapy in both groups, there was significantly better outcome for patients who have presented without obstruction.

HOW TO CITE THIS ARTICLE

Ul Haq MF, Bhat GA, Wani MA, . Outcome of Obstructing vs Nonobstructing Colorectal Carcinomas: Comparative Study at Tertiary Care Hospital in Kashmir. Euroasian J Hepato-Gastroenterol 2024;14(1):75-80.

摘要

背景

结直肠癌（CRC）是常见的诊断出的恶性肿瘤，可表现为梗阻或无梗阻。肠梗阻（BO）通常是晚期癌症的并发症，会显著降低生活质量。我们旨在研究这些需要紧急干预的梗阻性结直肠癌的治疗结果，并将其与非梗阻性癌症进行比较。

材料与方法

在我们的观察性比较研究中，根据患者的表现和病变部位将患者分为几组：非梗阻性结肠组/梗阻性结肠组、非梗阻性直肠组/梗阻性直肠组。

结果

纳入了2015年至2018年间共232例已知表现方式的患者；144例结肠癌，88例直肠癌，其中71例为完全梗阻性。我们的研究表明梗阻组的复发率更高，局部复发更为常见。梗阻组复发的中位间隔时间较早（<0.001*）。非梗阻性结肠组的总体5年生存率更好，（OR与NOR相比=-0.046*）（OC与NOC相比=-0.031*）。5年无病生存率无统计学意义（NOC组和OC组=0.203），（NOR组和OR组=0.307）。术后即刻，除手术部位感染外，两组并发症无显著差异。我们的研究表明，与梗阻组相比，NOC组的R0切除比例更高（OC与NOC相比=0.021*，OR与NOR相比=0.037*），NOC组的淋巴结清扫情况更好。