减瘤手术对不可治愈的结直肠癌患者生存时间的影响

The effect of palliative resection on incurable colorectal cancer survival

目的研究除手术切除外未经任何其他治疗的不可治愈的结直肠癌患者，行原发肿瘤切除对患者生存时间的影响。方法收集143例除手术切除外未经任何其他治疗的不可治愈的结直肠癌患者的临床资料，其中91例予姑息性切除（减瘤手术组），52例未切除（非手术组）。比较原发肿瘤切除对患者生存时间的影响。结果减瘤手术组中位生存时间（10个月）明显长于非手术组（3个月），P〈0．01；只有远处转移不合并有癌性腹水和种植转移者手术切除原发肿瘤患者中位生存时间（10个月）明显长于非手术切除患者（3个月），P〈0．01。术后并发症两组比较差异无统计学意义（P〉0．05）。结论原发结直肠癌患者减瘤手术在技术上是可行的，不会造成癌扩散，能够提高患者的生存质量和延长患者的生存时间。

Objective To quantify the benefit of primary tumor removal in patients with differently presenting incurable colorectal cancer,while no other therapy combined. Methods One hundred and forty-three consecutive patients were operated for incurable colorectal cancer （91 undergoing resective and 52 non-resective procedures）, with the purpose of comparing homogenous populations and of identifying whether the patients got benefit from primary tumor resection. Results In patients with resectable primary tumors, resective procedures were associated with longer median survival than non-resective procedures （ 10 months vs 3 months ）, patients with distant spread without neoplastic a.seites/implanting metastasis got benefit from primary tumor removal （P 〈 0.01 ）. The complication of resective procedures was not significantly different from that of non-resective procedures （P 〉 0.05）. Conclusion Palliative resection of primary colorectal cancer should be pursued in patients with unresectable distant metastasis whenever the primary tumor is technically resectable.