多原发大肠癌37例临床分析

目的 探讨多原发大肠癌的临床特点、诊断治疗及预后。方法 对1974-1998年37例多原发大肠癌进行回顾性分析。结果 37例占同期收治原发大肠癌的2．74％(37／1348)，其中同时多原发大肠癌15例，异时多原发大肠癌22例，癌灶部位以右半结肠和直肠为多，异时多原发大肠癌55％(12／22)在3年内发生，41％(9／22)在8年后发生，全部癌灶除1例外均得到根治性切除，同时多原发大肠癌5年生存率为5／9，异时多原发大肠癌5年生存率为15／21，二次癌术后5年生存率为7／18。结论 提高对多原发大肠癌的警惕性，术前全面检查，术中仔细探查，术后定期复查，争取早期发现，积极手术治疗，以提高生存率。

Clinical analysis of multiple primary colorectal carcinoma

Objective To investigate clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma (MPCC). Methods A retrospective analysis was made on 37 patients with MPCC admitted from 1974 to 1998. ResultsThe incidence of MPCC was 2 74%(37/1 348) with 15 cases being synchronous carcinoma (SC) and 22 cases diagnosed as metachronous carcinomas (MC). Most tumors were located in right colon and rectum. Twelve out of twenty-two (55%) of MC were diagnosed within 3 years from the primary operation and 41% (9/22) of MC occurred after 8 years. JP2Radical resections were performed in all patients except for 1 case. The 5 year survival rate of SC was 5/9 and that of MC after the first cancer or second cancer were 15/21 and 7/18, respectively. Conclusions The results indicated the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and active radical resection can increase survival rate of MPCC.