四例同时性原发性直肠癌合并前列腺癌的临床治疗分析  

Clinical analysis four cases of synchronous primary rectal and prostate cancer

作　　者：邓科[1] 龙慧民[2] 崔巍[1] 汪闻夕[1] 

机构地区：[1]宁波市医疗中心李惠利医院肛肠科,315040 [2]宁波市医疗中心李惠利医院泌尿外科,315040

出　　处：《中华结直肠疾病电子杂志》2017年第5期427-432,共6页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的直肠癌和前列腺癌是男性常见的盆腔恶性肿瘤,有关同时性原发性直肠癌合并前列腺癌的文献报道非常少,结合宁波市医疗中心李惠利医院对同时性原发性直肠癌合并前列腺癌的治疗经验,初步探讨其临床特点、诊断、综合治疗及预后。方法回顾性分析宁波市医疗中心李惠利医院2013~2015年间收治的4例同时性原发性直肠癌合并前列腺癌患者的临床及随访资料。其中3例行同期根治性手术;1例仅行直肠癌根治术。3例术后接受化疗及内分泌治疗;1例仅接受内分泌治疗。结果术后1位患者PSA一直处于较高水平,其余3位患者随访至今未见复发。结论我们认为同时性原发性直肠癌合并前列腺癌患者的预后可能要好于单发直肠癌或前列腺癌的转移或复发。对于适宜患者积极开展同期根治性手术可取得良好疗效,并在治疗全程中强调个体化治疗,术后需依照相关指南给予放化疗及内分泌治疗,以期患者获得更长的远期生存。Objective Adenocarcinoma of the rectum and prostate are common male pelvic cancers. There is limited published data related to synchronous primary rectal and prostate cancer. To present a detailed analysis of patients clinical characteristics, diagnosis, treatment and prognosis with synchronous primary rectal and prostate cancer. Methods Clinical data of 4 patients with synchronous primary rectal and prostate cancer who were admitted to the Anorectal Department of the Lihuili Hospital of Ningbo Medical Center from 2013 to 2015 were collected. Patient clinical characteristics and follow-up data were retrieved. We performed radical resection of rectal cancer with prostatectomy for 3 patients including 2 patients by totally laparoscopic procedure, only radical resection of rectal cancer for 1 patients. 3 patients received postoperative chemotherapy and hormonal therapy, 1 patient only received postoperative hormonal therapy. Results The lasting high prostate-specific antigen level was observed in one patient after operation, the others 3 patients had no evidence of tumor recurrence. Conclusions Our experience suggests that the synchronous primary rectal and prostate cancer could had a better survival prognosis than metastasis and recurrence of rectal cancer and prostate cancer. We conclude that efficient, aggressive radical resection of rectal cancer with prostatectomy can be designed for suitable patients with synchronous primary rectal and prostate cancers, and the treatment modality should be carefully made and tailored on the individual patient suffering from this disease. Due to the realistic potential for longterm survival, we recommend aggressive postoperative treatment of these patients, include chemoradiation and hormonal therapy according to guideline.

关 键 词：直肠肿瘤 外科手术 同时性多原发癌 前列腺癌 

分 类 号：R735.37[医药卫生—肿瘤] R737.25[医药卫生—临床医学]