结肠癌和直肠癌根治性切除术后复发模式分析

Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum.

作者信息

Malcolm A W, Perencevich N P, Olson R M, Hanley J A, Chaffey J T, Wilson R E

出版信息

Surg Gynecol Obstet. 1981 Feb;152(2):131-6.

PMID:7209752

Abstract

The records of 525 patients with adenocarcinoma of the colon and rectum were reviewed. Two hundred and eighty-five patients were evaluable following complete curative resections. These patients were evaluated for patterns of recurrence. The over-all recurrence rate was 78 of 285, 27 per cent. The over-all recurrence rate by site was 24.0, 10.0, 11.5 and 35.0 per cent for the right, transverse and left colon, the sigmoid and the rectum, respectively. The over-all failure rate by stage was 13 per cent for Stage A, 11 per cent for Stage B1, 32 per cent for Stage C1, 37 per cent for Stage B2-3 and 56 per cent for Stage C2-3. The over-all failure rate as related to Stages A, B1, C1, B2-3 and C2-3 and to site of primary disease was: right--zero, 9, 33, 28 and 43 per cent, sigmoid--11, 15, 40, 52 and 62 per cent; rectal group--29, 14, 40, 46 and 60 per cent as related to respective stages. There was one failure among the five patients with Stage B2-3 disease in the transverse group and two failures among the nine patients with Stage B2-3 and one failure in the one patient with Stage C2-3 within the left colon group. Individual types of failure were compiled. Lesions involving the rectum and sigmoid colon had a significant local-regional component to relapse. Tumors of the right, transverse and the left colon had a significant distant recurrence rate. Factors of primary site, age at diagnosis, extent of disease and histology were reviewed as to the over-all recurrence and specific failure sites. From this analysis, a schema involving patterns of failure as related to primary site and stage within the colon, rectum and sigmoid were developed.

摘要

回顾了525例结肠和直肠癌患者的记录。285例患者在根治性切除术后可进行评估。对这些患者的复发模式进行了评估。285例患者中总体复发率为78例，占27%。按部位划分的总体复发率分别为：右半结肠24.0%、横结肠10.0%、左半结肠11.5%、乙状结肠35.0%和直肠35.0%。按分期划分的总体失败率为：A期13%，B1期11%，C1期32%，B2 - 3期37%，C2 - 3期56%。与A、B1、C1、B2 - 3和C2 - 3期以及原发疾病部位相关的总体失败率为：右半结肠——分别为0、9%、33%、28%和43%，乙状结肠——分别为11%、15%、40%、52%和62%；直肠组——与各分期相关的分别为29%、14%、40%、46%和60%。横结肠组中5例B2 - 3期疾病患者中有1例失败，左半结肠组中9例B2 - 3期患者中有2例失败，1例C2 - 3期患者中有1例失败。对个体失败类型进行了汇总。累及直肠和乙状结肠的病变有显著的局部区域复发成分。右半结肠、横结肠和左半结肠的肿瘤有显著的远处复发率。对原发部位、诊断时年龄、疾病范围和组织学等因素与总体复发及特定失败部位的关系进行了回顾。通过该分析，制定了一种涉及与结肠、直肠和乙状结肠内原发部位和分期相关的失败模式的方案。