Lateral local recurrence after total mesorectal excision for mid/low rectal cancer: study of clinical characteristics and impact of salvage surgery on survival
Lateral local recurrence after total mesorectal excision for mid/low rectal cancer: study of clinical characteristics and impact of salvage surgery on survival
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中低位直肠癌全直肠系膜切除术后侧方局部复发：临床特征及挽救手术对生存影响的研究
DOI：
10.1093/bjs/znac190
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发表时间：
2022
影响因子：
9.6
通讯作者：
Fukunaga Yosuke
中科院分区：
文献类型：
--
作者：
Kiyozumi Yuki;Akiyoshi Takashi;Mukai Toshiki;Hiyoshi Yukiharu;Nagasaki Toshiya;Yamaguchi Tomohiro;Konishi Tsuyoshi;Fukunaga Yosuke
方法和结果本研究的详细方法在补充材料中提供。1384例入选患者的基线特征见表S1。术后中位随访时间为63（iqr 57-75）个月。在随访期间，281名患者（20.3%）复发。复发部位见表S2。共有78名患者（5.6%）出现局部复发。在局部复发的患者中，LLR发生率最高（74%），其次是吻合口（13%）、骶前（0%）、前路（1%）和会阴（1%）复发。所有78例局部复发患者最初均接受了R 0切除术。在根据接受（C）RT的分析中，LLR仍然是接受和未接受（C）RT的患者局部复发的主要亚位点：16/19 vs 42/59。（C）RT患者中无吻合口复发：0/19 vs 10/59（P= 0.017）。总队列中LLR的5年累积发生率为4.0%（95% CI 3.0至5.1%）。
Methods and resultsDetailed methods for this study are provided in the Supplementary material. Baseline characteristics of 1384 included patients are shown in Table S1. The median follow-up after surgery was 63 (iqr 57–75) months. During follow-up, 281 patients (20.3 per cent) developed recurrence. The sites of recurrence are shown in Table S2. In total, 78 patients (5.6 per cent) developed local recurrence. Among those with local recurrence, LLR occurred most frequently (74 per cent), followed by anastomotic (13 per cent), presacral (0 per cent), anterior (1 per cent), and perineal (1 per cent) recurrence. All 78 patients with local recurrence had initially undergone R0 resection. In analyses according to receipt of (C) RT, LLR was still the major subsite of local recurrence both among patients who did and those who did not have (C) RT: 16/19 versus 42/59. There were no instances of anastomotic recurrence among patients who had (C) RT: 0/19 versus 10/59 (P= 0.017). The 5-year cumulative incidence of LLR among the total cohort was 4.0 (95 per cent ci 3.0 to 5.1) per cent.