消化道多原发性癌

Multiple primary cancer of digestive tract

目的 探讨消化道多原发癌的临床特点及其诊治。方法 回顾性分析 33例消化道多原发癌的临床资料。结果 本组病例占同期消化道癌的 2 7% ,其中同时癌 (SC) 2 4例 ,漏诊2 0例 ,分别行根治切除、中药、化疗等综合治疗。异时癌 (MC) 9例 ,漏诊 1例 ,分别行根治切除、姑息切除及放疗。总 5年生存率为 45 4% ,SC为 37 5 % ,MC为 5 5 5 %。结论 消化道多原发癌发病率低 ,术前漏诊率高 ,应行综合性诊断方法。对病变应行根治性手术与再手术切除。

Objective To study the clinical features, diagnosis and treatment of multiple primary cancer of digestive tract (MPCDT). Methods The clinical data of 33 cases of MPCDT were analysed retrospectively. Results The incidence of MPCDT was 2.7% in all patients with primary cancer of digestive tract. 24 cases was synchronous carcinoma (SC), of whom, 20 was misdignosis. All the cases of SC received comprehensive treatment, including radical resection, traditional medicine and radiotherapy respectively. 9 cases were metachronous carcinoma (MC), of them, only 1 case misdiagnosed. All the MC cases received radical resection, palliative resection and radiotherapy. The 5 year survival rate in cases of MPCDT, SC and MC were 45.4%, 37.5% and 55.5% respectively. Conclusions The incidence of MPCDT is low, but misdiagnosis rate is hight. For MPCDT, comprehensive treatment, and radical resection and re operation should be done. It is advisable not to diagnose MC as recurrence or metastasis.