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膀胱癌侵犯的结肠癌:单中心经验。

Colon Cancer With Bladder Invasion: A Single Center Experience.

机构信息

Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.

Division of Colorectal Surgery, Department of Surgery, Chiayi Branch, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.

出版信息

In Vivo. 2024 Nov-Dec;38(6):2990-3001. doi: 10.21873/invivo.13782.

Abstract

BACKGROUND/AIM: The aim of our study was to investigate the outcome of colon cancer with bladder invasion after surgical intervention.

PATIENTS AND METHODS

Between 2011 and 2022, a total of 41 patients diagnosed with colon cancer and bladder invasion underwent surgical procedures at Taichung Veterans General Hospital. The impact of various risk factors on overall survival (OS) was assessed using Kaplan-Meier analyses and Cox proportional hazards models.

RESULTS

Among the enrolled patients, 21 underwent radical cystectomy, while 20 underwent partial cystectomy. Twelve had tumors located in the rectum, 19 in the sigmoid colon, and 10 in both the rectum and sigmoid colon. The median OS was 71.8 months in stage 2, 50.8 months in stage 3, and 11.2 months in stage 4 (p=0.061). Median OS was 71.8 months in patients with negative surgical margins and 10.5 months in those with positive surgical margins (p=0.003). In multivariate regression analysis, positive surgical margins [hazard ratio (HR)=3.64, 95% confidence interval (CI)=1.28-10.34, p=0.015] and emergency operations (HR=4.57, 95%CI=1.34-15.55, p=0.015) significantly impacted OS.

CONCLUSION

Complete resection of colon cancer with bladder invasion can yield excellent oncologic outcomes. The decision between partial and radical cystectomy should balance surgical margin clearance and the preservation of quality of life. Both surgical margin involvement and emergency operations are independent risk factors for OS.

摘要

背景/目的:本研究旨在探讨经手术干预后合并膀胱侵犯的结肠癌患者的预后。

患者与方法

2011 年至 2022 年间,共有 41 例诊断为结肠癌合并膀胱侵犯的患者在台中荣民总医院接受了手术治疗。采用 Kaplan-Meier 分析和 Cox 比例风险模型评估各种风险因素对总生存期(OS)的影响。

结果

入组患者中 21 例行根治性膀胱切除术,20 例行部分膀胱切除术。12 例肿瘤位于直肠,19 例位于乙状结肠,10 例位于直肠和乙状结肠。2 期患者的中位 OS 为 71.8 个月,3 期为 50.8 个月,4 期为 11.2 个月(p=0.061)。切缘阴性患者的中位 OS 为 71.8 个月,切缘阳性患者为 10.5 个月(p=0.003)。多因素回归分析显示,切缘阳性(HR=3.64,95%CI=1.28-10.34,p=0.015)和急诊手术(HR=4.57,95%CI=1.34-15.55,p=0.015)是影响 OS 的独立危险因素。

结论

完全切除合并膀胱侵犯的结肠癌可获得良好的肿瘤学结果。在部分膀胱切除术和根治性膀胱切除术之间的选择应权衡手术切缘的清除和生活质量的保留。手术切缘受累和急诊手术都是 OS 的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/606b/11535905/92189b430813/in_vivo-38-2992-g0001.jpg

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