Classification of rectal cancer according to recurrence types-comparison of Japanese guidelines and Western guidelines  

作　　者：Hiroshi Miyakita Yutaro Kamei Lin Fung Chan Kazutake Okada Hajime Kayano Seiichiro Yamamoto 

机构地区：[1]Department of Digestive System Surgery,Tokai University School of Medicine,Isehara 259-1193,Kanagawa,Japan

出　　处：《World Journal of Clinical Cases》2022年第36期13284-13292,共9页世界临床病例杂志

摘　　要：BACKGROUND Rectal cancer is characterized by more local recurrence(LR)and lung metastasis than colon cancer.However,the diagnosis of rectal cancer is not standardized as there is no global consensus on its definition and classification.The classification of rectal cancer differs between Japanese and Western guidelines.AIM To clarify the characteristics of rectal cancer by comparing the tumor location and characteristics of rectal cancer with those of colon cancer according to each set of guidelines.METHODS A total of 958 patients with Stage II and III colorectal cancer were included in the analysis:607 with colon cancer and 351 with rectal cancer.Localization of rectal cancers was assessed by enema examination and rigid endoscopy.According to Japan guidelines,rectal cancer is classified as Rb(below the peritoneal inversion),Ra(between the inferior margin of second sacral vertebrae and Rb)or RS(between Ra and sacral promontory).RESULTS There were no significant differences between RS rectal cancer and colon cancer in the rates of liver and lung metastasis or LR.Lung metastasis and LR were significantly more common among Rb rectal cancer(in Japan)than in colon cancer(P=0.0043 and P=0.0002,respectively).Lung metastases and LR occurred at significantly higher rates in rectal cancer measuring≤12 cm and≤10 cm than in colon cancers(P=0.0117,P=0.0467,P=0.0036,P=0.0010).Finally,the rates of liver metastasis,lung metastasis,and LR in rectal cancers measuring 11 cm to 15 cm were 6.9%,2.8%,and 5.7%,respectively.These were equivalent to the rates in colon cancer.CONCLUSION High rectal cancer may be treated with the same treatment strategies as colon cancer.There was no difference in the classification of colorectal cancer between Japan and Western countries.

关 键 词：Colon cancer Metastasis Local recurrence Classification of rectal cancer Western guidelines Japanese guideline 

分 类 号：R735.34[医药卫生—肿瘤]