不同手术方式治疗结直肠癌腹膜转移患者预后效果分析

目的 分析不同手术方式对结直肠癌腹膜转移患者预后的影响。 方法 回顾性分析2010年5月-2014年6月在浙江省立同德医院行手术治疗的结直肠癌腹膜转移患者98例,根据手术方式的不同将其分为完全性切除组35例、不完全性切除组34例和减状手术组29例,分析3组患者的临床病理资料及术后生存情况,并采用Cox比例风险模型分析不同手术方式治疗结直肠癌患者的预后情况。 结果 本研究98例患者均获得随访,随访率100%,随访时间为0.5~40.0个月,平均生存时间为(16.9±4.5)个月,1年、3年总生存率分别为40.8%(40/98)和18.4%(18/98);完全性切除组平均生存时间为(28.6±6.2)个月,1年、3年总生存率分别为71.4%(25/35)和45.7%(16/35),不完全性切除组平均生存时间为(11.2±4.1)个月,1年、3年总生存率分别为26.5%(9/34)和0,减状手术组平均生存时间为(10.9±3.2)个月,1年、3年总生存率分别为13.8%(4/29)和0,完全性切除组患者的平均生存时间和1年、3年总生存率均明显高于不完全性切除组和减状手术组(P<0.05),不完全性切除组患者的平均生存时间和1年、3年总生存率与减状手术组比较,差异无统计学意义(P>0.05);Cox分析显示,分化程度、PCI、原发灶T分期和手术方式是影响结直肠癌腹膜转移患者预后的主要因素。 结论 结直肠癌腹膜转移患者采取完全性切除手术预后效果较好,值得临床推广应用。 

Prognostic analysis of different surgical approaches in treating colorectal cancer peritoneal metastasis

Objective To analyze the different surgical methods on the prognosis of patients with peritoneal metastasis of colorectal cancer. Methods Retrospective analysis of 98 cases of peritoneal metastasis in patients with rectal cancer from May, 2010 to June, 2014 in our hospital, they were devided into complete resection group (35 cases), incomplete resection group (34 cases) and subtraction surgery group (29 cases) according to the different surgical methods, the clinicopathological data and postoperative survival of the three groups were analyzed, and Cox proportional risk model was used to analyze the prognosis of patients with colorectal cancer. Results In this study, 98 patients were followed up, and the follow-up rate was 100%, the follow-up time was 0.5-40.0 months, the mean survival time was (16.9±4.5) months, and the total survival rate was 40.8% (40/98) and 18.4% (18/98) in 1 year and 3 years respectively; Complete resection group average survival time was (28.6±6.2) months, the total survival rate was 71.4% (25/35) and 45.7% (16/35) in 1 year and 3 years, incomplete resection group average survival time was (11.2±4.1) months, the total survival rate was 26.5% (9/34) and 0 in 1 year and 3 years, subtraction surgery group average survival time was (10.9±3.2) months, the total survival rate was 13.8% (4/29) and 0 in 1 year and 3 years, the mean survival time, 1 year and 3 years of total survival rate in complete resection group were significantly higher than those in incomplete resection group and subtraction group (P<0.05), the mean survival time, 1 year, 3 years of total survival rate in incomplete resection group were not statistically significant with subtraction surgery group (P>0.05); Cox analysis showed that differentiation degree, PCI, primary stage T stage and operation mode were the main factors affecting the prognosis of patients with peritoneal metastasis of colorectal cancer. Conclusion Peritoneal metastasis of colorectal cancer patients with complete resection of the prognosis is better, and it is worthy of clinical application.