24例符合Amsterdam诊断标准的异时结直肠癌患者的生存分析  

Survival analysis of 24 patients with metachronous colorectal cancer meeting the Amsterdam criteria

作　　者：周欣[1] 杨柳[1] 张晓梅[2] 李东正[1] 朱明[2] 关心[1] 余东升[1] 仲坚[1] 蒋谦[1] 陈森清[2] Zhou Xin;Yang Liu;Zhang Xiaomei;Li Dongzheng;Zhu Ming;Guan Xin;Yu Dongsheng;Zhong Jian;Jiang Qian;Chen Senqing(Department of General Surgery,Jiangsu Cancer Hospital and the Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu,China;Laboratory of Genetics and Molecular Biology,Jiangsu Institute of Cancer Research,Nanjing 210009,Jiangsu,China)

机构地区：[1]南京医科大学附属江苏省肿瘤医院普外科,江苏南京210009 [2]江苏省肿瘤防治研究所遗传和分子生物学实验室,江苏南京210009

出　　处：《结直肠肛门外科》2019年第3期279-283,共5页Journal of Colorectal & Anal Surgery

基　　金：江苏省医学重点人才项目(RC2011092)

摘　　要：目的探讨符合Amsterdam诊断标准的异时结直肠癌患者根治手术后生存情况、再次发生异时结直肠癌的风险和死亡原因。方法回顾性分析2000年6月至2016年12月南京医科大学附属江苏省肿瘤医院收治的24例符合Amsterdam诊断标准并接受根治性手术的异时结直肠癌患者术后生存与再次发生异时结直肠癌的随访资料,记录预后及探讨死亡原因。结果本组患者生存中位随访105个月,共有8位患者死亡,其中非肿瘤死亡3例、因肿瘤死亡5例(2例因肠癌去世,3例因肠外恶性肿瘤去世),5年和10年总体生存率分别为96%和53%,结直肠癌特异5年和10年生存率分别为100%和82%。再次发生异时结直肠癌中位随访93个月,共有6例(25%)患者术后再发,5年和10年再次异时结直肠癌累计发病率分别为15%和41%。结论符合Am?sterdam诊断标准的异时结直肠癌患者术后生存预期较好,再次发生异时结直肠癌的风险较高。肠外恶性肿瘤和结直肠癌均是死亡的重要原因,术后异时结直肠癌和肠外恶性肿瘤的筛查或早期诊断都应该受到重视,手术治疗可以考虑扩大结直肠切除。Objectives To investigate survival,incidence of subsequent metachronous colorectal cancer, and cause of death in patients with metachronous colorectal cancer fulfilling the Amsterdam criteria. Methods This was a retrospective analysis of 24 patients with metachronous colorectal cancer fulfilling the Amsterdam criteria treated with curative surgery in Jiangsu Cancer Hos. pital and the Affiliated Cancer Hospital of Nanjing Medical University between June 2000 and December 2016. We analyzed fol. low-up data of their postoperative survival, incidence of subsequent metachronous colorectal cancer, and causes of death. Results Median survival was 105 months. There were eight deaths, three of which were not cancer-related and five of which were can. cer-related (two due to colorectal cancer and three due to other cancer). Overall five-and ten-year survival rates were 96% and 53%, respectively. Colorectal cancer-specific survival rates were 100% and 82%, respectively. Median time to diagnosis of subsequent metachronous colorectal cancer was 93 months. Six (25%) patients developed subsequent metachronous colorectal can. cer. Cumulative five-and ten-year incidence of subsequent metachronous colorectal cancer were 15% and 41%, respectively. Conclusion Overall survival of metachrnous colorectal cancer fulfilling the Amsterdam criteria was satisfactory, but risk of subse. quent metachronous colorectal cancer was high. Major causes of death were colorectal cancer and other cancers. Attentions should be given to postoperative screening and early diagnosis of metachronous colorectal cancer and other malignancies. If neces. sary, extended resection of colon and rectum could be considered.

关 键 词：异时结直肠癌 Amsterdam标准 术后生存 

分 类 号：R735.3[医药卫生—肿瘤]