摘要
目的分析直肠癌局部复发(LRRC)患者的临床资料特点。方法回顾性分析2000年1月至2016年1月于本科室接受治疗的1302例直肠癌患者临床资料,对LRRC患者基于不同解剖分类分析原发肿瘤的临床资料差异,记录LRRC治疗情况。结果LRRC发生率为8.6%(112/1302),男性占65.2%,老年患者占55.4%。将患者按照不同解剖分类分为中心型45例(40.2%),后向型30例(26.8%),前向型20例(17.9%),侧向型17例(15.2%),不同解剖分类之间性别、年龄、肿瘤距肛缘距离、术前CEA、手术类型、吻合口漏、肿瘤最大径、术后辅助治疗、T分期、N分期及淋巴结检出数目比较,差异均无统计学意义(均P>0.05),手术方式比较差异有统计学意义(P<0.05)。67.9%的LRRC在原发肿瘤术后2年内发生,50.9%的患者诊断LR?RC时合并远处转移。不同分型的患者是否存在复发症状、CEA异常情况比较差异均有统计学意义(均P<0.05),复发时间及是否合并远处转移情况比较差异均无统计学意义(均P>0.05),是否接受根治性切除干预情况比较差异有统计学意义(P<0.05)。结论LRRC患者中以中心型最为常见,R0切除率相对较高,但出现复发症状及异常CEA占比一般,开展有效的患者管理和加强随访具有重要的临床意义。
Objectives To analyze the clinical characteristics of the patients with locally recurrent rectal cancer(LRRC).Methods The clinical data of 1,302 patients with rectal cancer who were treated at our department between January 2000 and Janu?ary 2016 were retrospectively analyzed.The clinical characteristics of primary tumors of LRRC were analyzed based on the differ?ent anatomical classification.The treatment of LRRC patients was recorded.Results The incidence of LRRC was 8.6%(112/1,302),65.2%were male and 55.4%were elderly patients.Patients were divided according to different anatomical classification:central type(n=45,40.2%),backward type(n=30,26.8%),forward type(n=20,17.9%),and lateral type(n=17,15.2%).There were no significant differences in gender,age,tumor distance from the anal verge,preoperative carcinoembryonic antigen(CEA)level,type of surgery,anastomotic leakage,maximum diameter of tumor,postoperative adjuvant therapy,T stage,N stage,and lymph node yield(P>0.05),the difference in surgical approach was significantly different(P<0.05).Local recurrence occurred in 67.9%of patients within two years after surgery for primary tumor,and 50.9%of patients had distant metastasis at the time of LRRC diagnosis.Recurrence symptoms,CEA abnormalities differed significantly among different types of patients(P<0.05).There was no significant difference in the time of recurrence and whether there were distant metastases(P>0.05).There was significant difference in radical resection treatment among different types of patients(P<0.05).Conclusion The central type was the most common type in LRRC patients,with a relatively high R0 resection rate but no pronounced recurrence symptoms and abnormal CEA as a whole.It was of great clinical importance to conduct effective patient management and follow-up.
作者
徐开盛
李永柏
杨杰熙
王波
王少勇
Xu Kaisheng;Li Yongbai;Yang Jiexi;Wang Bo;Wang Shaoyong(Department of General Surgery,Guizhou Provincial People’s Hospital,Guiyang 550000,Guizhou,China)
出处
《结直肠肛门外科》
2020年第2期188-191,212,共5页
Journal of Colorectal & Anal Surgery
基金
贵州省科学技术基金项目(黔科合J字2012-2229号)。
关键词
直肠癌
局部复发
临床病理特征
预后
rectal cancer
local recurrence
clinicopathological characteristics
prognosis
