直肠癌前切除术后局部复发患者38例治疗分析

目的]探讨直肠癌前切除术后局部复发患者治疗方式的选择。方法]对中国医学科学院中国协和医科大学肿瘤医院腹部外科1999年1月～2007年12月间收治38例直肠癌前切除术后局部复发资料进行回顾性研究，分析治疗方式及其对预后的影响。结果]平均随访时间25．9±18.3个月，局部复发治疗后的1、3、5年总体生存率分别为78．7％、32．8％、21．5％，行根治性手术组的1、3、5年总体生存率分别为91．7％、71．3％、53．5％，姑息性治疗组的1、3、5年总体生存率分别为66．0％、11．4％、0。结论]直肠癌前切除术后局部复发患者应争取再次行根治性切除术，能否行根治性手术是影响预后的独立因素。

An Analysis of Treatment Strategy for 38 Cases with Locally Recurrent Rectal Cancer after Anterior Resection

Purpose] To assess the therapeutic options of locally recurrent rectal cancer who underwent management with anterior resection. Methods] A retrospective review was performed in 38 cases with locally recurrent rectal cancer after anterior resection between Jan. 1999 and Dec. 2007 in department of abdominal surgery, cancer hospital of Chinese academy of medical science. Management and impact of outcome on these patients were analyzed. Results] The mean followup period was 25.9±18.3 months. The overall 1, 3. 5-year survival rate was 78.7%, 32.8% and 21.5% respectively. The 1, 3, 5-year survival rate ot radical surgery group was 91.7%, 71.3% and 53.5%, and of palliative treatment group was 66.0%, 11.4% and 0 respectively. Conclusion] A radical resection is a prerequisite for cure of locally recurrent rectal cancer after anterior resection, and the radical surgery is the independent prognostic indicator.