- 期刊
Should Rectosigmoid Junction Cancer be Classified as Colon or Rectal Cancer in pT3N0M0 Cases? Clinical Results under Different Adjuvant Therapeutic Modalities
在病理期別T3N0M0的直腸乙狀結腸連接處惡性腫瘤視為大腸癌還是直腸癌治療：不同輔助性治療的臨床結果
摘要
Purpose. Whether or not rectosigmoid junction cancer should be classified as colon or rectum cancer in the classification of diseases has been a controversial issue due to tumor location. The aim of this study was to compare the different treatment modality results in pT3N0M0 rectosigmoid junction cancer. Method. Between January 2007 and December 2015, a total of 67 patients who underwent radical surgery of the primary tumor with a pathologic diagnosis of adenocarcinoma of the rectosigmoid junction (T3N0M0) were retrospectively enrolled in this study. Fifteen patients received adjuvant concurrent chemoradiotherapy after radical surgery and the other 52 patients were observed clinically without further adjuvant therapy. The clinicopathologic features, recurrence pattern, and prognosis of the two groups were analyzed. Result. Elder predominance was noted in the surgery only group compared with the surgery with adjuvant concurrent chemoradiotherapy group (70.42 ± 10.14 years vs. 61.07 ± 10.30 years, p = 0.0050). There was no significant difference in gender, co-morbidity, primary tumor size, number of lymph nodes harvested, distal margin of the resected tumor, post-operative complications, and recurrence rate between the two groups. Distant metastases were the most common recurrence pattern in both groups (50% vs. 80 %, p = 0.4545). There was no significant difference in overall, disease- free, and cancer-specific survival between the two groups. Conclusion. Post-operative concurrent chemoradiotherapy group did not provide significant survival benefit for pT3N0M0 rectosigmoid colon cancer.
並列摘要
目的：臨床上，乙狀結腸與直腸交界處的腫瘤，因其位置應該歸類為直腸或者大腸腫瘤，目前仍有爭議。本回顧性研究目的，是要分析病理上診斷為T3N0M0乙狀直腸交接處腫瘤，術後有無化放療治療的預後。方法：從2007年1月至2015年12月，在奇美醫學中心有86位被診斷為乙狀直腸交界處T3N0M0腫瘤，排除高風險族群後，最後有67名患者列入本研究。15名病人手術後接受後續化放療治療；52名病人接受手術治療而無後續化放療。我們分析比較各組的臨床病理特徵及其治療結果。結果：單純手術組與手術後併輔助性同步放射及化學治療組相比，患者有較老的診斷年齡（70.42 ± 10.14 比61.07 ± 10.30, p = 0.0050）。兩組在性別、合併症、原發腫瘤大小、採集淋巴結數量，切除腫瘤遠端邊緣距離，術後併發症，復發率並無顯著性差異。遠處轉移是兩組中最常見的復發模式（50% vs. 80%, p = 0.4545）。兩組在總體生存率，無病生存率和癌症特異性生存率上，兩組並無明顯統計學上差異。結論在診斷為T3M0N0的乙狀直腸連接處之腫瘤，術後輔助性同步電化療並沒有提供顯著的生存益處。