直肠前切除术后局部复发癌治疗方式选择及预后研究

发布时间：2018-05-03 02:12

本文选题：直肠局部复发癌 + 治疗方式　；参考：《中国实用外科杂志》2017年09期

【摘要】：目的探讨直肠前切除术后局部复发癌的精准治疗方式。方法回顾性分析辽宁省肿瘤医院2008年2月至2014年9月收治的178例直肠前切除术后局部复发癌的临床资料,分析不同治疗方式与病人预后的关系。结果 178例病人的总生存期为(32.8±1.2)个月。根治性切除病人生存期优于姑息性切除病人[(40.8±1.4)个月vs.(27.5±1.6)个月]。直接行根治性切除与放疗后根治性切除病人生存期差异无统计学意义[(41.3±1.5)个月vs.(38.6±2.6)个月]。直接行姑息性切除和放疗后姑息性切除及造口病人,三者之间生存期差异无统计学意义[(27.8±1.6)个月vs.(25.8±4.5)个月vs.(23.9±4.9)个月]。局部复发肿瘤直接姑息性切除病人的预后好于行放化疗病人[(27.8±1.6)个月vs.(16.4±2.2)个月]。但放疗后姑息性切除病人与行放化疗病人的生存期差异无统计学意义。结论对于复发肿瘤应争取行根治性手术。如果肿瘤不可切除,应通过放化疗手段进行转化治疗后,再行根治性手术。姑息性切除手术应慎重选择,特别对于复发肿瘤放疗后仍不能达到根治性切除的病人,提示肿瘤的生物学行为不佳,治疗应以对症为主。
[Abstract]:Objective to investigate the accurate treatment of local recurrent cancer after anterior rectal resection. Methods the clinical data of 178 patients with locally recurrent cancer after anterior rectal resection in Liaoning Cancer Hospital from February 2008 to September 2014 were retrospectively analyzed and the relationship between different treatment methods and the prognosis of patients was analyzed. Results the total survival time of 178 patients was 32.8 卤1.2 months. The survival time of radical resection patients was better than that of palliative resection patients [40.8 卤1.4 months vs.(27.5 卤1.6 months]. There was no significant difference in survival between radical resection and radiotherapy [41.3 卤1.5 months vs.(38.6 卤2.6 months]. There was no significant difference in survival between patients undergoing palliative resection and postoperative palliative resection and operation after radiotherapy [27.8 卤1.6 months, vs.(25.8 卤4.5 months, vs.(23.9 卤4.9 months]. The prognosis of patients with local recurrence tumor was better than that of patients undergoing radiotherapy and chemotherapy [27.8 卤1.6 months vs.(16.4 卤2.2 months]. However, there was no significant difference in survival between patients undergoing palliative resection and patients undergoing radiotherapy and chemotherapy. Conclusion radical operation should be performed for recurrent tumors. If the tumor is unresectable, radical surgery should be performed after chemotherapy and radiotherapy. Palliative resection should be carefully selected, especially for the patients who can not reach radical resection after radiotherapy, suggesting that the biological behavior of the tumor is not good, and the treatment should be mainly symptomatic.
【作者单位】：中国医科大学肿瘤医院辽宁省肿瘤医院结直肠外科;
【基金】：辽宁省科学事业公益研究基金(No.2016003002)
【分类号】：R735.37

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