Clinicopathologic Characteristics and Outcomes of Patients with Obstructive Colorectal Cancer
Clinicopathologic Characteristics and Outcomes of Patients with Obstructive Colorectal Cancer
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阻塞性结直肠癌患者的临床病理特征和结果
DOI：
10.1007/s11605-011-1563-1
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发表时间：
2011-07-01
影响因子：
3.2
通讯作者：
Wang, Jianping
中科院分区：
文献类型：
--
作者：
Yang, Zuli;Wang, Lei;Wang, Jianping
目的本回顾性研究的目的是分析结直肠癌梗阻患者的临床病理特征和短期和长期的结果相比，非梗阻性结直肠癌patients.Methodsbetween 1998年1月至2005年12月，1,672例结直肠癌患者接受手术纳入本研究。根据表现将患者分为两组：接受急诊手术的完全梗阻性结直肠癌（COC，n = 215）患者和接受择期手术的非梗阻性结直肠癌（NOC，n = 1，457）患者。回顾性分析1,672例结直肠癌患者的临床病理特征及近、远期预后。COC组与NOC组在肿瘤位置、大小、大体类型、浸润深度、肝转移、腹膜转移和TNM分期等方面存在差异。Logistic回归分析显示肿瘤位置、浸润深度和腹膜转移是梗阻的独立相关因素。与无梗阻患者相比，梗阻患者的死亡风险增加了2.251倍。腹膜癌转移和TNM分期是影响COC组生存的独立因素。梗阻、腹膜癌转移、肿瘤大体类型和TNM分期是术后复发的独立指标。COC组的术后死亡率明显高于NOC组。COC组的5年和10年总生存率分别为47.8%和42.8%，而NOC组分别为67.2%和59.8%（p 0.05）。术后复发率COC组为43.1%，NOC组为32.8%（p0.05）。与NOC组相比，COC组患者的总体生存率更差，术后复发率更高。
PurposeThe aim of this retrospective study was to analyze the clinicopathologic characteristics and short-term and long-term outcomes of colorectal cancer patients with obstruction compared to those of non-obstructive colorectal cancer patients.MethodsBetween January 1998 and December 2005, 1,672 colorectal cancer patients undergoing operation were enrolled in this study. Patients were classified into two groups according to the presentation: patients with complete obstructive colorectal cancer (COC, n = 215) receiving emergency procedures and patients with non-obstructive colorectal cancer (NOC, n = 1,457) receiving elective procedures. The data on the clinicopathologic characteristics and short-term and long-term outcomes of patients were analyzed retrospectively.ResultsAmong 1,672 colorectal cancer patients, 215 cases presented with complete obstruction. The distribution of tumor location and size, macroscopic type, depth of invasion, liver metastasis, peritoneal carcinomatosis, and TNM stage were found to be different between the COC and NOC groups. Logistic regression analysis showed that tumor location, depth of invasion, and peritoneal carcinomatosis were independent factors associated with obstruction. Patients with obstruction had an increased risk of death by a factor of 2.251 compared to patients without obstruction. Peritoneal carcinomatosis and TNM stage were independent factors for the survival of the COC group. Obstruction, peritoneal carcinomatosis, tumor macroscopic type, and TNM stage were independent indicators for postoperative recurrence. Postoperative mortality was significantly higher in the COC group than the NOC group. The overall 5- and 10-year survival rates in the COC group were 47.8% and 42.8%, respectively, compared to 67.2% and 59.8% in the NOC group, respectively (p < 0.05). The postoperative recurrence rates were 43.1% in the COC group and 32.8% in the NOC group (p < 0.05).ConclusionsObstruction is an independent indicator for the survival and postoperative recurrence for patients with colorectal cancer. Patients in the COC group have worse overall survival with high postoperative recurrence rate compared to those in the NOC group.