摘要
目的 探讨直肠癌Miles′术后局部复发的诊断和治疗方法。方法 回顾性分析 1985年～ 1998年收治的 5 6例直肠癌Miles′术后局部复发患者的临床病例资料。结果 11例再次手术切除 ,45例放射治疗。复发时间为 3～ 10 5个月 ,中位复发时间为 14个月 ,2年内复发占 78.6% ,3年内复发占 89.3 %。CT诊断准确率为 85 .4% ,MRI诊断准确率为 85 .7% ,CT引导下穿刺活检阳性率为 88.2 %。手术治疗组中位生存期为 3 3个月 ,放射治疗组中位生存期 2 5个月 ,手术组中位生存期较放疗组长 8个月 ,但无显著性差异。结论 直肠癌Miles′术后 3年内应密切随访 ,以便早期诊断、及时治疗。诊断直肠癌Miles′术后复发最常用的方法是行盆腔CT、MRI检查 ,最可靠的方法是CT引导下穿刺活检。对直肠癌Miles′术后局部复发患者应争取再次手术切除 ,对不能手术切除的患者 ,可行放射治疗 ,以缓解症状 。
Objective To explore the diagnosis and treatment of locally recurrent rectal cancer after Miles′ operation.Methods 56 cases of locally recurrent rectal cancer after Miles′ operation from 1985 to 1998 were analyzed retrospectively.Results 11 patients underwent re operation and 45 received radiotherapy.The time between the surgery and the detection of the recurrent lesion was 3 to 105 months,with median 14 months.78.6% of the patients were diagnosed as recurrence in 2 years and 89% in 3 years.The accurate rates of CT scan and MRI for detecting local recurrence were 85.4% and 85.7% respectively.The positive rate of CT guided needle biopsy was 88.2%.Median survival was 33 months in the re operation group,and 25 months in the radiotherapy group.There was no significant difference between the two groups( P >0.05).Conclusion Fellow up should be performed periodically for patients with rectal cancer after Miles′ operation in first 3 years so as to detect the recurrence lesion early.Pelvic CT scan and MRI are the commonest way to detect local recurrence and CT guided needle biopsy is regarded as the most valuable and reliable method.A re operation should be performed for locally recurrent rectal cancer after Miles′ operation.The patients with unresectable local recurrence may receive radiotherapy to relieve their symptoms and survive longer.
出处
《实用癌症杂志》
2003年第1期85-86,94,共3页
The Practical Journal of Cancer
关键词
直肠癌
复发
诊断
治疗
Rectal neoplasm
Recurrence
Diagnosis
Treatment
