透過您的圖書館登入
IP:3.237.178.126
  • 期刊

Metachronous Krukenberg Tumors from Colorectal Cancer - A 12-year Study in a Medical Center

源發自大腸直腸癌之異時性庫肯堡氏腫瘤-來自某醫學中心的十二年研究

摘要


Purpose. We performed this study to evaluate the clinical presentation and survival after proper surgical intervention for Krukenberg tumor (KT) from colorectal cancers (CRC) and these tumors were identified during postoperative follow-up. This will help to establish the optimal strategy for improving the survival. Materials and Methods. A total of 2,191 female patients with primary CRC were diagnosed at our hospital between January 2001 and December 2012, and 26 patients (1.19%) with metachronous KT from CRC were collected for survival analyses. Parameters included patient age at the time of ovarian relapse, the size of the tumor, the initial TNM stage of the colorectal cancer, the interval to metastasis and the presence of gross residual disease after treatment for KT. Results. The average age of the patients with metachronous KT was 49.77 years (range: 31 to 75 years) and the average survival time of the 26 patients was 23.94 months with a range of 3 to 93 months after the diagnosis of KT. The 5-year survival rate was 6.6% for all patients with KT from CRC and the 5-year survival rate for patient with R0 resection was 18.8%. The survival rate for patients without gross residual disease was longer than those with gross residual disease (p < 0.001). In contrast, menstrual status, the lymph node involvement status, and the interval to metastasis were not prognostic indicators for survival after the development of KT. Conclusions. Early diagnosis and complete resection had benefits to improve survival. The 5-year survival rate was 6.6% for all patients with KT from CRC and the 5-year survival rate for patient with R0 resection was 18.8%. Therefore, attempts to resect tumors as the second tumor reduction seem worthwhile.

並列摘要


目的 本研究主要目的用於評估大腸癌術後庫肯堡氏腫瘤之臨床表現以及手術介入之預後。使我們能夠更恰當地制定治療策略以改善預後。方法 自2001 年到2012 年為止,在本院共2191 位女性因大腸直腸癌接受手術治療,其中有26 位 (1.19%) 病患在術後追蹤時發現庫肯堡氏腫瘤並接受手術治療。治療前臨床TMN 分期、腫瘤大小、病患年紀、手術後是否有殘存腫瘤、以及存活率都被收集與分析。結果 異時性庫肯堡氏腫瘤病患平均年紀為49.77 歲,庫肯堡氏腫瘤診斷後平均存活時間為23.94 個月,源發自大腸直腸癌之異時性庫肯堡氏腫瘤病患五年存活率為6.6%,而無殘餘腫瘤之病患五年存活率為18.8%。手術後無殘存腫瘤的病人較手術後有殘存腫瘤者有較高之存活率並達統計學上之顯著意義 (p < 0.001)。結論 早期診斷以及根治性手術對病人之存活有益。源發自大腸直腸癌之異時性庫肯堡氏腫瘤病患五年存活率為6.6%,而無殘餘腫瘤之病患五年存活率為18.8%。因此積極手術治療切除庫肯堡氏腫瘤值得一試。

並列關鍵字

異時性 卵巢轉移 大腸直腸癌 存活率

參考文獻


Nakamura Y, Hamamatsu A, Koyama T, Oyama Y, Tanaka A, Honma K. A Krukenberg Tumor from an Occult Intramucosal Gastric Carcinoma Identified during An Autopsy. Case Rep Oncol Med.2014;2014:797429."
Serov SF, Scully RE, Sobin LH. International Histological Classification of Tumors. No. 9. Histological Typing of Ovarian Tumours. Geneva : World Health Organization, 1973:1-56."
Fujiwar K, Ohishi Y, Koike H, Sawada S, Moriya T, Kohno I. Clinical implications of metastases to the ovary. Gynecol Oncol. 1995;59.1: 124-8."
Moore RG, Chung M, Granai CO, Gajewski W, Steinhoff MM. Incidence of metastasis to the ovaries from nongenital tract primary tumors. Gynecol Oncol. 2004;93(1):87-91."
Kim DD, Park IJ, Kim HC, Yu CS, Kim JC. Ovarian metastases from colorectal cancer: a clinicopathological analysis of 103 patients. Colorectal Dis. 2009;11(1):32-8"

延伸閱讀