Elective palliative resection of incurable stage IV colorectal cancer: Who really benefits from it?
Elective palliative resection of incurable stage IV colorectal cancer: Who really benefits from it?
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DOI：
10.1007/s00595-009-4253-9
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发表时间：
2011-02-01
期刊：
影响因子：
2.5
通讯作者：
Violi, Vincenzo
中科院分区：
文献类型：
--
作者：
Costi, Renato;Di Mauro, Davide;Violi, Vincenzo
尽管无法治愈的结直肠癌(CRC)患者的化疗结果令人鼓舞，但外科手术切除原发肿瘤仍然是世界范围内常见的方法。找出与短生存期(6个月)相关的预后因素可以排除那些不能从中受益的人。对71名接受非紧急姑息性初次切除的不治之症结直肠癌患者的15个变量进行了回顾性分析，包括患者的人口统计学和肿瘤的临床/组织病理学特征。没有变量与围手术期死亡率(8.5%)相关。多因素分析显示，高龄(80岁)和超过25%的淋巴结转移与生存期(分别为4个月和6个月)有关。因此，粘液腺癌倾向于与预后相关(P=0.070)。对于患有不治之症的结直肠癌患者，老年人倾向于禁忌症地进行选择性原发肿瘤切除。在计划大的结肠手术前，也应该考虑大量的淋巴转移和粘液腺癌。
Despite the encouraging results of chemotherapy in patients affected by incurable colorectal cancer (CRC), surgical resection of a primitive tumor is still a common approach worldwide. The identification of prognostic factors related to short survival (< 6 months) may allow excluding from resective surgery those who may not benefit from it.A retrospective analysis was performed of 15 variables in a population of 71 patients undergoing nonemergency palliative primary resections of incurable CRC, including patients' demographics and clinical/histopathological characteristics of the tumor.No variables were related to perioperative mortality (8.5% overall). A multivariate analysis revealed that older age (a parts per thousand yen80 years) and metastasis to more than 25% of the lymph nodes were associated with survival (4 and 6 months, respectively). Mucoid adenocarcinoma therefore tends to be associated with the prognosis (P = 0.070).An elderly age tends to be a contraindication to an elective primary tumor resection in patients affected by incurable CRC. Massive lymph node involvement and mucoid adenocarcinoma should also be considered before planning major colonic surgery.