结肠癌与直肠癌根治术后复发的比较研究

Comparative study of recurrent colon cancer and recurrent rectal cancer after radical resection

目的 探讨肿瘤根治术后复发的结肠癌与直肠癌患者生物学行为及预后差异.方法 回顾性分析132例结直肠癌（结肠癌36例,直肠癌96例）根治术后复发患者的临床资料,对其中结肠癌与直肠癌患者的临床病理特征及预后进行比较分析.结果本组结肠癌与直肠癌复发者其原发肿瘤在大体类型、组织学类型、分化程度及淋巴结转移方面的差异有统计学意义（P＜0.05）.结肠癌组与直肠癌组中位复发时间分别为14.0个月和21.5个月（P=0.028）;并分别有16例（44.4%）和65例（67.7%）多部位复发（P=0.014）;两组复发后3年生存率分别为15.6%和24.8%（P=0.026）;上述差异均有统计学意义.结论 结肠癌与直肠癌在肿瘤生物学行为上存在着一定差异,直肠癌复发患者预后优于结肠癌复发者.

Objective To explore the difference in tumor biological behaviors and prognosis between recurrent colon cancer and recurrent rectal cancer after radical operation. Methods Complete clinical and follow-up data of 132 patients with colorectal cancer developed recurrence,including 36 colon cancers and 96 rectal caners, after curative resection were retrospectively analyzed and compared with respect of clinical pathological features and prognosis between colon and rectal cancer.Results Significant differences were found in primary tumor gross type, histological type, tumor differentiation and lymph node metastasis between colon and rectal cancer （P〈0.05）. Colon cancer recurred earlier than rectal cancer after radical surgery with the median time to recurrence being 14.0 months and 21.5 months, respectively （P=0.028）. The difference in multiple sites recurrence was also found between colon （n=16,44.4%） and rectal cancer （n=65,67.7%）（P=0.014）. The 3-year survival rate of recurrent rectal cancer was better than that of colon cancer （24.8% vs 15.6% ,P=0.026）.Conclusion There are some differences in tumor biological behaviors between colon and rectal cancer,and the prognosis of rectal cancer with recurrence is better than that of colon cancer.