Impact of Rectal Cancer Level on Pulmonary Metastases in Rectal Cancer Patients Who Received Neoadjuvant Therapy with Curative-intent Surgery

直腸癌位置顯著影響根治性手術前接受輔助性治療患者之肺部轉移

鄭景中(Ching-Chung Cheng) ； 江支銘(Jy-Ming Chiang)

《中華民國大腸直腸外科醫學會雜誌》 30卷1期 (2019/03) Pp. 1-8

https://doi.org/10.6312/SCRSTW.201903_30(1).10717

摘要

Purpose. The impact of preoperative neoadjuvant therapy on distal metastases remained unclear. This study aims to analyze the surgical outcomes and characterize the rates and the patterns of recurrence in rectal cancer patients. Methods. Patients with rectal cancers received neoadjuvant radiotherapy followed with curative-intent surgery between January 2008 and December 2012 were recruited in this study. Recurrence patterns and survival rates were calculated in relation to clinical variables and rectal cancer levels. Results. There were 310 patients enrolled in this study. Patients with low-rectal cancer had significantly worse three, and five-year overall survival (78.5% and 66.1%, respectively) than patients with middle-rectal cancer (83.5% and 77.0%, respectively). The level of the tumor (p = 0.026) and nodal status (p ＜ 0.001) significantly affected the surgical outcomes related to disease-free survival in multivariate analyses. Furthermore, significantly higher incidence rates of lung metastases in low-rectal cancer than in middle-rectal cancers (p = 0.008) were also observed. Conclusions. For rectal cancer patients who underwent neoadjuvant radiotherapy with curative-intent surgery, the level of the rectal cancer significantly affected the surgical outcomes as well as pulmonary recurrence.

關鍵字

Rectal cancer ； Neoadjuvant therapy ； Pulmonary metastases

並列摘要

目的：直腸癌患者手術前接受輔助性治療對於其後續發生遠端轉移之影響目前尚未有一致的結論，本研究針對根治性手術前接受輔助性治療之直腸癌患者分析其預後及轉移狀況。方法：挑選本院2008年至2012年進行根治性手術前接受輔助性治療之直腸癌患者，分析比較直腸癌位置與長期存活率及復發轉移模式。結果：本研究總共分析310位患者，低位直腸癌相對於中位直腸癌有較差之三年及五年存活率（分別為78.5%、66.1%及83.5％、77%），直腸癌位置（p＝0.026）及淋巴結轉移（p＜0.001）對於術後癌症相關存活率有顯著影響；此外，低位直腸癌相對於中位直腸癌有較高肺部轉移的機會（p＝0.008）。結論：對於根治性手術前接受輔助性治療之直腸癌患者，直腸癌位置顯著影響手術預後及肺部轉移機會。

並列關鍵字

直腸癌 ； 術前輔助性治療 ； 肺部轉移

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