The Result of Treatment for Locally Recurrent Rectal Cancer

直腸癌局部復發之治療

黃立婉(Lap-Yuen Wong) ； 林楨國(Jen-Kou Lin) ； 林資琛(Tzu-Chen Lin) ； 陳維熊(Wei-Shone Chen) ； 姜正愷(Jeng-Kae Jiang) ； 楊純豪(Stung-Haur Yang) ； 王煥昇(Huann-Sheng Wang) ； 張世慶(Shih-Ching Chang)

《中華民國大腸直腸外科醫學會雜誌》 14卷3期 (2003/09) Pp. 75-81

https://doi.org/10.6312/SCRSTW.2003.14(3).09201

摘要

背景及目的　局部復發直腸癌是一個困難的臨床問題。百分之三至三十的宜腸癌病人於接受根治性手術後會有復發現象。治療方法包括手術治療，化學治療，放射戰療，或混合式治療。本研究之目的是以迴逆性的方法來評估局部復發直腸癌的病人以不同之治療方法的結果及預後。
方法　於1980至1999年，共2139病人患直腸癌，其中1704病人接受根治性手術。其中96(15.7%)病人有局部復發合併或無合併遠端轉移。47 (29.8%)病人發現為單一局部復發，於研究中會記錄病人之年齡、發病時間及症狀、初次手術種類及分期、術後輔助治療與否、再手術之種類及存活率。
結果　47位病人中14位接受再次治癒性手術，5年存活率為百分之八十二。47位病人中17位接受姑息手術，5年存活率為百分之二十六。47位病病人中11位接受化學治療，放射治療，或兩者合併治療，5年存活率為百分之二十七。
結論　再次治癒性手術對於局部復發直腸癌的存活率及局部控制均較其他治療方法好。

關鍵字

直腸癌 ； 化學治療 ； 放射治療 ； 治癒性手術 ； 姑息手術

並列摘要

Background. The incidence of locoregional recurrence after radical surgery of rectal cancer occurs 3% to 30%. The management of locally recurrent cancer includes surgery, chemotherapy, radiotherapy or the combination of these modalities. The aim of this retrospective study is to evaluate the results and outcome of different methods of management of the locally recurrent rectal cancer.
Materials and Methods. From 1980 to 1999, there were 2139 patients diagnosed to haven primary rectal cancer and 1704 patients received curative resection. The patients were followed up regularly by a special cancer registry team in the hospital. The medical records were reviewed retrospectively. Totally there were 96 patients diagnosed to have locally recurrent disease. In these, 47 cases were isolated local recurrence. The results of the treatment of these 47 patients were evaluated.
Results. Fourteen of 47 (29.8%) patients received intensive curative resection. Of these, 10 of 14(71.4%) were still alive without disease, with a 5-years survival rate of 82%. Seventeen of 47 (36.2%) patients underwent palliative resection, with a 5-years survival rate of 26%. Eleven of 47 (23.4%) patients received radiotherapy and/or chemotherapy, with a 5-years survival rate of 27%.
Conclusions. The intensive curative resection of locoregional recurrence is associated with much better survival and achieved better local control.

並列關鍵字

Rectum ； Carcinoma ； Locally recurrence ； Treatment