联合脏器切除治疗局部进展期结肠癌

Multivisceral resection for locally advanced colon cancer

目的探讨对局部进展期结肠癌患者行联合脏器切除的疗效及影响预后的因素。方法回顾性分析1988～1998年对47例结肠癌患者进行联合脏器切除治疗的临床资料,对其肿瘤复发模式及患者生存率进行统计分析。结果本组患者有7例(14.9%)术后出现并发症,无死亡病例。病理证实周围组织器官有肿瘤侵犯30例(63.8%);局部复发8例(17.0%),远处转移16例(34.0%);5年生存率为40.4%。多因素分析,肿瘤UICC分期及淋巴结转移是影响预后的重要因素(P<0.05)。结论对于局部进展期结肠癌累及周围组织脏器的患者,应力争联合脏器切除治疗。

Objective To evaluate the efficacy of multivisceral resection and prognostic factors for locally advanced colon cancer. Methods A retrospective analysis of 47 patients who underwent multivisceral resection for locally advanced colon cancer from 1988 to 1998 was carried out. Patterns of recurrence and 5 year survival were analyzed. Results Microscopic tumor infiltration was demonstrated in 30 patients (63.8%). Seven patients(14.9%)developed postoperative complications. There were no peri operative death. Local recurrence and distant metastasis rates were 17.0%(8/47) and 34.0%(16/47)respectively. The overall 5 year survival rate was 40.4%. Univariate analysis revealed that lymph node metastases, tumor stage and adjacent organ infiltration were correlated with the prognosis, while multivariate analysis revealed only lymph node metastasis and UICC stage were independent prognostic factors(P< 0.05). Conclusion Patients with locally advanced colon cancer adherent to other organs should be treated by multivisceral resection.