Multivisceral resection for locally advanced primary colon and rectal cancer - An analysis of prognostic factors in 201 patients
Multivisceral resection for locally advanced primary colon and rectal cancer - An analysis of prognostic factors in 201 patients
复制标题
DOI：
10.1097/00000658-200202000-00009
复制
发表时间：
2002-02-01
影响因子：
9
通讯作者：
Herfarth, C
中科院分区：
文献类型：
--
作者：
Lehnert, T;Methner, M;Herfarth, C
目的回顾201例多脏器切除原发性结直肠癌的单中心经验，以确定术中预测潜在治愈的准确性，确定预后因素，并检查手术经验对近期结果和远期结果的影响。摘要背景资料局部进展期结直肠癌可能需要术中决定将周围器官或结构整体切除以实现肿瘤完全切除。这一决定必须权衡多脏器切除的并发症和死亡风险与潜在的生存益处。关于结直肠癌多脏器切除的预后因素和手术经验对预后的影响，目前知之甚少。方法从一个前瞻性数据库中筛选1982-1998年间接受多脏器切除的原发性结直肠癌患者。结果2712例患者中201例行多脏器切除，中位年龄为。201例患者术后并发症发生率为33%，死亡率为7.5%。在201例患者中，130例(65%)有可能进行潜在的根治性切除，44%的根治性切除患者组织学肿瘤浸润性病变。术中对可治愈性的评估并不可靠。根治性切除后局部复发率为11%，总的5年生存率为51%。多因素分析显示术中出血量(相对危险度1.7~6.4，P
Objective To review a single-center experience with 201 multivisceral resections for primary colorectal cancer to determine the accuracy of intraoperative prediction of potential curability, to identify prognostic factors, and to examine the effect of surgical experience on Immediate outcome and long-term results,Summary Background Data Locally advanced colorectal cancer may require an Intraoperative decision for en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications and death of multivisceral resection against a potential survival benefit. Little is known about prognostic factors and the influence of surgical experience on the outcome of multivisceral resection for colorectal cancer.Methods Patients undergoing multivisceral resection for primary colon or rectal cancer between 1982 and 1998 were identified from a prospective database. Patients were followed up according to a standard protocol,Results Multivisceral resection was performed in 201 of 2,712 patients with a median age of 64 years. Postoperative rates of complications and death in 201 patients were 33% and 7.5%, respectively. A potentially curative resection was possible in 130 of 201 patients (65%) and histologic tumor infiltration was shown In 44% of patients with curative resection. Intraoperative assessment of curability was unreliable. After curative resection, the local recurrence rate was 11% and the overall 5-year survival rate was 51%. Multivariate analysis identified intraoperative blood loss (relative risk 1.7-6.4, P