直肠癌术后局部复发的治疗与预后分析

Treatment and prognostic analysis of local recurrence rectal cancer

目的分析直肠癌根治术后局部复发患者的生存状况及影响因素。方法回顾性分析四川省肿瘤医院2013年10月至2018年1月收治的35例单纯性直肠癌局部复发患者的资料,分析其生存状况,并采用多因素Cox回归分析影响预后的相关因素。结果35例患者中男20例,女16例;中位生存期125(6~144)个月,5年存活率为53.1%。中位复发时间17(4~88)个月。其中手术治疗15例,姑息放化疗11例,化疗6例,拒绝手术及放化疗3例,4种治疗方法的5年存活率分别为71.5%、35.4%、53.3%、33.3%,差异无统计学意义(P=0.148)。多因素分析结果显示:复发时间间隔>12个月及确诊时血红蛋白>120 g/L是预后良好的独立影响因素。结论直肠癌局部复发多发生于术后2年内,1年内出现局部复发提示预后不良;对直肠癌局部复发患者应根据复发类型积极进行综合治疗。

Objective To analyze the survival status and influencing factors of patients with local recurrent rectal cancer(LRRC).Methods Clinical and pathological data of 35 patients with LRRC in Sichuan Cancer Hospital from October 14,2013 to January 30,2018 were analyzed retrospectively.Results Among the 35 patients,20 were male and 16 were female;The median survival time was 125(6-144)months,and the 5-year survival rate was 53.1%.The median recurrence time was 17(4-88)months.The 5-year survival rate of 15 patients underwent surgical treatment was 71.5%,11 patients received palliative chemoradiotherapy was 35.4%,6 patients received only chemotherapy was 53.3%,3 patients denied further treatment was 33.3%.There was no significant difference in treatment patterns(P=0.148).Multi-factor analysis showed that hemoglobin>120 g/L and local recurrent time were independent prognostic factors(both P<0.05).ConclusionsThe LRRC occurred within 2 years after operation.Local recurrent time within 1 year indicated poor prognosis.Patients with local recurrence of rectal cancer should actively adopt comprehensive treatment according to the recurrence type of recurrence.