结肠癌术后局部复发的现状和进展

结肠癌是消化系统最常见的恶性肿瘤之一.手术是结肠癌最主要的治疗方式,而术后局部复发是决定结肠癌患者生存率及生活质量的重要因素,并且是目前评价手术质量的一项重要指标.因肠梗阻和肠穿孔行急诊手术是局部复发的独立危险因素,T和N分期、肿瘤大体形态、神经血管是否受侵也是影响局部复发的重要因素.目前认为对于有适应证的患者行再次手术仍可获得较好的预后,全部切除复发肿瘤并且达到阴性切缘(R0切除)是获得长期生存的首要条件.再手术后切缘病理状况、局部复发部位、复发肿瘤数目及大小、肿瘤分期、术前血清CEA的水平、是否存在远处转移均是影响术后肿瘤特异性生存率的独立因素.

Postoperative local recurrence of colon cancer

Colon cancer is one of the most common cancers in the gastrointestinal system.Surgical resection remains the primary treatment of colon cancer.Local recurrence after colon cancer surgery has an important influence on survival and quality of life of the patient and has recently been widely used as an index of surgical expertise.Emergency operation due to obstruction and perforation is an independent factor for local recurrence as well as T and N staging,gross feature,angiolymphatic and perineural invasion.Salvage surgery for locoregional recurrence of colon cancer could provide a chance for long-term survival in selective patients.Resection of recurrent tumor and achievement of negative margin(R0 resection) are the primary conditions for the long-term survival of the patient.Margin status after reresection,number,size and site of locoregional recurrent tumors,TNM staging,CEA level,and distant metastasis are independently associated with cancer-specific survival.