摘要
目的探讨直肠癌骶前复发的临床病理学特征及预后因素。方法回顾性分析2008年1月至2015年12月北京大学人民医院诊断为直肠癌骶前复发的47例病人的资料。对病人临床病理学信息及随访资料进行回顾性队列研究,采用Cox比例风险模型分析直肠癌骶前复发的预后影响因素。结果 47例病人中,男性30例,女性17例,男女比1.8:1.0,随访时间18(2～72)个月。中位复发年龄59(34～83)岁,中位复发间隔时间2年,21例(44.7%)病人以疼痛为主要临床表现,中位生存时间为25(1～65)个月,单因素分析显示原发肿瘤病理学分期、骶前复发治疗方式和R0切除与否与预后相关,多因素分析示,R0切除、原发肿瘤病理学分期Ⅰ/Ⅱ期、原发肿瘤术后无辅助治疗是预后良好的独立影响因素。结论直肠癌骶前复发病人多发生于术后2年内,以疼痛为主要临床表现,接受R0切除的病人预后较好。
Objective To investigate the clinicopathological features and prognosis in patients with presacral recurrent rectal cancer. Methods Clinical data of 47 patients with presacral recurrent cancer in Peking University People＇ s Hospital from January 2008 to December 2015 were retrospectively reviewed. The clinicopathological and follow up data of these 47 patients were analyzed retrospectively, and Cox proportional hazard model was used to analyze the prognostic factors of presacral recurrent rectal cancer. Results Among above 47 patients, 30 were male and 17 were female, with a male-to-female ratio of 1.8：1.0, followed up for 18（2-72）months. The median recurrent age was 59（range： 34 to 83） years and the median recurrent gap time was 2 years. The main symptom in 44.7% （21/47） patients was pain. The overall median survival time was 25（range： 1 to 65） months. Univariate analysis showed that primary tumor stage, treatment methodand R0 resection influenced prognosis. The result of multivariate analysis demonstrated that RO resection, primary tumor stage Ⅰ/Ⅱ/, primary therapy without adjunctive therapy were independent good prognostic factors. Conclusion Patients tend to diagnosis presacral recurrent rectal cancer within 2 years after primary surgery. The main symptom is pain. Patients performed RO resection have a relative good prognosis.
作者
郭鹏
王畅
谢启伟
姜可伟
尹慕军
杨晓东
梁斌
申占龙
叶颖江
王杉
GUO Peng;WANG Chang;XIE Oi-wei(Department of G! surgery,People＇s Hospital,Peking University,Beijing 100010,China)
出处
《中国实用外科杂志》
CSCD
北大核心
2018年第11期1305-1309,共5页
Chinese Journal of Practical Surgery
基金
北京市科技计划项目(No.Z161100000516104)
关键词
直肠癌
复发
预后
rectal cancer
recurrence
prognosis
