Incidence and patterns of recurrence after resection for cure of colonic cancer in a well defined population
Incidence and patterns of recurrence after resection for cure of colonic cancer in a well defined population
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DOI：
10.1002/bjs.5349
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发表时间：
2006-09-01
影响因子：
9.6
通讯作者：
Faivre, J.
中科院分区：
文献类型：
--
作者：
Manfredi, S.;Bouvier, A. M.;Faivre, J.
背景资料：本研究的目的是确定的发病率和模式失败后，潜在的根治性手术的结肠cancer.Methods：数据来自癌症登记的Cote-D 'Or（法国）。对1976 ~ 2000年2657例结肠癌手术治疗的资料进行分析。使用精算方法和多变量分析进行了计算本地和远程失败率考克斯model.Results：5年累积率为12.8%的局部复发和25.6%的远处转移。五年累积局部复发率为4.9%，第一阶段，第二阶段和第三阶段肿瘤的11.0%和23.5%（P < 0.001）。远处转移率分别为6.4%、21.4%和48.0%（P < 0.001）。1976-1980年和1996-2000年的5年累积远处转移率分别为31.7%和21.1%，局部复发率分别为17.6%和9.0%。多因素分析显示，局部复发率和远处转移率显著降低。癌症的扩展和呈现特征与失败的模式有关。肿瘤位置与局部复发的风险显着相关，而年龄和大体特征与远处转移的风险相关。结论：结肠癌切除后复发仍然是一个重大问题。术后3年的随访尤为重要。
Background: The aim of this study was to determine the incidence and patterns of failure following potentially curative surgery of colonic cancer.Methods: Data were obtained from the cancer registry of the Cote-d'Or (France). Data on 2657 patients who had resection for cure of colonic cancer between 1976 and 2000 were analysed. Local and distant failure rates were calculated using the actuarial method and multivariable analysis was performed using a Cox model.Results: The 5-year cumulative rate was 12.8 per cent for local recurrence and 25.6 per cent for distant metastases. Five-year cumulative local recurrence rates were 4.9 percent for stage I, 11.0 percent for stage II and 23.5 per cent for stage III tumours (P < 0.001). The corresponding rates for distant metastases were 6.4, 21.4 and 48.0 per cent (P < 0.001). The 5-year cumulative rates for distant metastases were 31.7 per cent for the period 1976-1980 and 21.1 per cent for 1996-2000, and the local recurrence rates were 17.6 and 9.0 per cent respectively. The decreases in rates of local recurrence and distant metastases were significant in multivariable analysis. Cancer extension and presenting features were related to patterns of failure. Tumour location was significantly associated with risk of local recurrence, whereas age and gross features were associated with risk of distant metastasis.Conclusion: Recurrence following resection of colonic cancer remains a substantial problem. Follow-up is of particular importance in the 3 years after surgery.