结肠癌全结肠系膜切除术患者的生存情况及其影响因素分析

Analysis of 5-year Survival Rate and its Influencing Factors in Patients with Colon Cancer undergoing Total Mesocolon Ectomy

目的:探讨全结肠系膜切除术对结肠癌患者生存状况及影响因素。方法:回顾性2011年1月—2014年12月本院收治的288例结肠癌患者的临床资料,分析结肠癌患者行全结肠系膜切除术后的生活质量、5年生存率及预后的影响因素。结果:术后30 d及90 d,癌症患者的生命质量测评表(FACY-G)评分均高于术前,汉密尔顿焦虑测评表(HAMA)及汉密尔顿抑郁量表(HAMD)评分均低于于术前,差异有统计学意义(P<0.05);288例患者术后随访5年,失访17例,随访率94.09%(271/288)。结肠癌患者经全结肠系膜切除术治疗后5年总生存率(OS)、无进展生存率(PFS)为75.00%、71.67%;Cox模型多因素分析结果显示Dukes分期为C期、病理类型为未分化及腺鳞癌、肿瘤细胞高分化程度、肿瘤位于左半结肠、肿瘤大于5cm、术中出血量大于200mL、有淋巴结转移均为结肠癌患者预后的危险因素(P<0.05)。结论:结肠癌患者行全结肠系膜切除术5年的生存率为75.00%,Dukes分期、病理类型、肿瘤细胞分化程度、肿瘤部位、肿瘤大小、术中出血量、淋巴结转移对患者术后5年生存率有影响。

Objective To investigate the survival status and influencing factors of total colonic mesentery excision on patients with colon cancer.Methods The clinical data of 288 patients with colon cancer treated in our hospital from January 2011 to December 2014 were retrospectively analyzed.The quality of life,5-year survival rate and prognostic factors of colon cancer patients after total mesocolon ectomy were analyzed.Results The quality of life(FACY-G)scores of cancer patients at 30 and 90 days after surgery were higher than those before surgery(P<0.05).Both the Hamilton Anxiety Assessment(HAMA)and Hamilton Depression Scale(HAMD)scores of preoperative patients were higher than those of the 30 days and 90 days after surgery(P<0.05).288 patients were followed up for 5 years after operation,17 were lost to follow-up.The follow-up rate was 94.09%and the overall 5-year overall survival rate(OS)and progression-free survival(PFS)of colon cancer patients after total mesocolonectomy were 75.00%and 71.67%.Multivariate analysis of Cox model proportions showed that Dukes stage,pathological type,tumor cell differentiation,tumor site,tumor size,intraoperative blood loss and lymph node metastasis were all prognostic risk factors for patients with colon cancer(P<0.05).Conclusion The 5-year survival rate of patients with colon cancer who underwent total mesocolon ectomy was 75.00%.Dukes stage,pathological type,tumor cell differentiation degree,tumor site,tumor size,intraoperative blood loss and lymph node metastasis have an effect on the 5-year survival rate of patients.