Trends in frequency and management of obstructing colorectal cancers in a well-defined population
Trends in frequency and management of obstructing colorectal cancers in a well-defined population
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DOI：
10.1007/s10350-007-9007-4
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发表时间：
2007-10-01
影响因子：
3.9
通讯作者：
Bouvier, Anne-Marie
中科院分区：
文献类型：
--
作者：
Cheynel, Nicolas;Cortet, Marion;Bouvier, Anne-Marie
背景：很少有基于人群的研究调查梗阻性结直肠癌。方法：收集1976年至2000年法国勃艮第基于人群的癌症登记处登记的13,331例结直肠癌的数据。结果：梗阻性癌占所有结直肠癌的8.3%。该比例在整个研究期间保持稳定。根治性切除率从54.9%（1976-1980）上升到71.4%（1996-2000; P=0.011）。使用多变量分析，癌症部位和诊断期是唯一与根治性切除显著相关的因素。梗阻性结直肠癌的术后死亡率从32.6%（1976-80）下降到15.2%（1996-2000; P < 0.001）。梗阻的存在与较高的术后死亡率显著相关，与年龄和肿瘤分期无关（比值比=2.55; 95%置信区间=2.13-3.5）。结论：梗阻性结直肠癌的发生率25年来保持不变。手术死亡率仍然很高，尽管已经出现了一些改善。必须努力在梗阻发生前诊断结直肠癌。大规模筛查是一种很有前途的方法。
BACKGROUND:Few population-based studies investigate obstructing colorectal cancers. This study was designed to describe trends in their frequency and management.METHODS:Data were obtained for 13,331 colorectal cancers registered by the population-based cancer registry of Burgundy, France, between the years 1976 and 2000.RESULTS:Obstructing cancers represented 8.3 percent of all colorectal cancers. This proportion was stable throughout the study. Resection for cure increased from 54.9 percent (1976-1980) to 71.4 percent (1996-2000; P=0.011). Using multivariate analysis, site of cancer and period of diagnosis were the only factors significantly associated to a curative resection. Postoperative mortality for obstructing colorectal cancers decreased from 32.6 percent (1976-80) to 15.2 percent (1996-2000; P < 0.001). The presence of obstruction was significantly associated with a higher postoperative mortality, independent of age and tumor stage (odds ratio=2.55; 95 percent confidence interval=2.13-3.5).CONCLUSION:The frequency of obstructing colorectal cancers has remained unchanged for 25 years. Operative mortality is still high, although some improvements have occurred. Efforts must be made to diagnose colorectal cancers before obstruction occurs. Mass screening represents a promising approach.