Wound recurrence following conventional treatment of colorectal cancer
Wound recurrence following conventional treatment of colorectal cancer
复制标题
结直肠癌常规治疗后伤口复发
DOI：
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发表时间：
1996
影响因子：
3.9
通讯作者：
M. O’connell
中科院分区：
文献类型：
--
作者：
Terence W. Reilly;H. Nelson;G. Schroeder;Sam H. Wieand;J. Bolton;M. O’connell
腹腔镜结肠切除术后套管针和提取部位肿瘤复发的报告引起了人们的关注，即与开放性结肠切除术相比，腹腔镜结肠切除术的复发率可能更高。在辅助治疗的时代，开放性结肠切除术后切口复发率的当代数据不可用。目得：本研究旨在检查当前前瞻性试验中伤口复发的发生率和临床特征，这些试验包括1，711例接受治愈治疗的原发性结肠或直肠腺癌患者。方法：回顾所有复发患者（n=623）的档案。分别记录每个复发部位。所有患者均进行了前瞻性随访，3年和4年的数据分别为100%和70%。344例患者的诊断分期为B2，1，367例患者为C（346例患者中>4个淋巴结阳性）。结果：在623例患者（36.4%）中发现复发，平均发生在初次治疗后1.5年。11例患者（0.6%）记录了切口复发（9例腹部伤口，1例会阴伤口和1例造口伤口）。只有4例被临床诊断，其余7例在再次手术时偶然诊断。在11例切口复发患者中，2例为原发性B2期，9例为原发性C期疾病。11例患者中有9例在复发时发现有多个部位复发。复发后平均随访1.8年，11例患者中有3例仍活着，但有8例因疾病死亡。结论：结直肠癌常规治疗后切口复发是不常见的，尽管可能被低估。它的发生通常是弥漫性腹腔内疾病的先兆。这些数据可能为结肠癌腹腔镜手术的研究提供有用的信息。
Reports of trocar and extraction site tumor recurrences following laparoscopic colectomy raise concern that such recurrences may be occurring more frequently with laparoscopic compared with open colectomy. Contemporary data on the incidence of incisional recurrence following open colectomy, in the age of adjuvant therapies, are not available. PURPOSE: This study was undertaken to examine the incidence and clinical features of wound recurrence in current prospective trials including 1,711 patients with primary adenocarcinoma of the colon or rectum treated for cure. METHODS: Files of all patients with recurrence (n=623) were reviewed. Each site of recurrence was recorded separately. All patients have been followed prospectively, and 3-year and 4-year data are mature on 100 and 70 percent, respectively. Stage at diagnosis was B2 in 344 patients and C in 1,367 patients (>4 nodes positive in 346 patients). RESULTS: Recurrence was identified in 623 patients (36.4 percent) and occurred at a mean of 1.5 years following primary treatment. Eleven patients (0.6 percent) had documented incisional recurrences (9 abdominal wound, 1 perineal wound, and 1 stoma wound). Only four were diagnosed clinically, and the remaining seven were diagnosed incidentally at reoperation. Of 11 patients with incisional wound recurrences, 2 had primary Stage B2 and 9 had primary Stage C disease. Nine of 11 patients were found to have multiple sites of recurrence at time of recurrence. At a mean follow-up of 1.8 years after recurrence, 3 of 11 patients are alive with disease, although 8 have died because of disease. CONCLUSIONS: Incisional recurrence is uncommon, although likely underestimated, following conventional treatment of colorectal carcinoma. Its occurrence is usually a harbinger of diffuse intra-abdominal disease. These data may provide useful information for investigations of laparoscopic approaches to colon cancer.
影响因子：
158.5
作者：
OCONNELL, M;MARTENSON, JA;RICH, TA
通讯作者：
RICH, TA
影响因子：
8.4
作者：
Witkamp, AJ;de Bree, E;Zoetmulder, FAN
通讯作者：
Zoetmulder, FAN