- 期刊
Clinical Outcome of Salvage Surgery for Stage Ⅲ Patients with Recurrent Colorectal Cancer
第三期大腸直腸癌復發的病患進行拯救性手術的臨床結果
摘要
目的 評估拯救性手術對於第三期大腸直腸癌復發病患的存活利益。 方法 以回溯性之方法從1996年至2001年，將在長庚紀念醫院共有568位第三期大腸直腸癌復發的病患作存活與拯救性手術之間的相關分析。 結果 進行拯救性手術的比例是30.3%，8年的整體存活率與癌症相關存活率明顯在有接受拯救性手術這一組比較高（14.4%與16.5% v.s. 5%與5.1%），只有切除復發的腫瘤才能得到比較長的存活期。8年的整體存活率與癌症相關存活率在切除肺腫瘤這一組是57.0%與57.0%，在切除肝腫瘤這一組是30.9%與35.0%，而在切除腹腔與骨盆腔其他腫瘤這一組則只有5%與7.1%，至於只有進行姑息手術而無腫瘤切除這一組則沒有長期的存活。雖然病人在接受拯救性手術切除肺腫瘤這一組得到最好的存活利益，其次是肝腫瘤這一組，但兩組間並無統計學上的差異。 結論 拯救性手術改善大腸直腸癌復發病患的存活，確實有些病患經由拯救性手術而痊癒。早期偵測到腫瘤的復發和適當的選擇病患，拯救性手術將會改善第三期大腸直腸癌復發病患的存活。
並列摘要
Purpose. The aim of this study is to evaluate the survival benefits of salvage surgery as a treatment for recurrent colorectal cancer in stage Ⅲ patients. Methods. We reviewed 568 cases (treated in Chang Gung Memorial Hospital between 1996 and 2001) of stage Ⅲ colorectal cancer with recurrence (including metastasis) and analyzed the survival outcomes associated with salvage surgery. Resutls. The rate of salvage surgery was 30.3%. The 8-year overall and cancer-specific survival rates were higher in patients who had undergone salvage surgery than in those who had not (14.4% and 16.5% v.s. 5.0% and 5.1% respectively, p＜0.01). The resection of tumors resulted in long-term survival. The 8-year overall and cancer-specific survival rates were 57.0% and 57.0%, respectively in patients who had undergone lung metasectomy, 30.9% and 35.0%, respectively in those who had undergone liver metasectomy, and 5.0% and 7.1%, respectively in those who had undergone resection of intra-abdominal and pelvic tumor. No long-term survival was noted in patients who had undergone palliative procedures without tumor resection. Although the patients who underwent salvage surgery of lung metasectomy had the best long-term survival outcomes, followed by those who underwent liver metasectomy, however, the observed difference in survival rates between the two types of salvage surgery was not statistically significant. Conclusion. Salvage surgery improved the survival prospects of recurrent colorectal cancer patients. In fact, some patients were cured by salvage surgery. Early detection of tumor recurrence and the appropriate identification of patients requiring salvage surgery are predicted to improve the survival rate of stage Ⅲ patients with recurrent colorectal cancer.
延伸閱讀
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