中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
3期
209-212
,共4页
李晓霞%孙公平%逯晓波%王辉
李曉霞%孫公平%逯曉波%王輝
리효하%손공평%록효파%왕휘
直肠肿瘤%外科手术%放射疗法%预后
直腸腫瘤%外科手術%放射療法%預後
직장종류%외과수술%방사요법%예후
Rectal neoplasms%Surgical procedures,operative%Radiotherapy%Prognosis
目的 探讨经肛门局部切除术治疗直肠癌的影响因素及预后.方法 回顾性分析1995-2008年116例采用经肛门局部切除术治疗直肠癌患者的临床资料,主要采用Cox比例风险模型进行多因素生存预后分析.结果 116例患者术后生存时间为14～160.5个月,中位生存时间为58.5个月.总体生存率5年为72%,10年为53%.局部复发16例,复发率为13.8%.单因素分析表明肿瘤的病理类型、浸润深度(T分期)、复发及转移均为预后影响因素.多因素回归分析表明肿瘤浸润深度(T分期)、复发转移情况是影响生存预后的独立因素.T_1期直肠癌患者,局部复发率为6.3%,5年生存率为93%,10年生存率为85%;T2期直肠癌患者,局部复发率为14.8%,5年生存率为63%,10年生存率为45%.T_1期患者接受辅助放疗后,无局部复发;T_2期患者接受放疗后,局部复发率为14.6%.接受辅助放疗与未接受辅助放疗患者的生存预后情况进行比较,通过绘制生存曲线发现无统计学意义(T_1:P=0.260,T_2:P=0.262).接受辅助放疗与未接受辅助放疗患者术后局部肿瘤复发情况进行比较有统计学意义(P=0.002).结论 经肛门局部切除术对于T_1期直肠癌治疗效果较好,T_2期直肠癌不适合采用经肛门局部切除术治疗.辅助放疗可降低术后直肠癌的局部复发率.
目的 探討經肛門跼部切除術治療直腸癌的影響因素及預後.方法 迴顧性分析1995-2008年116例採用經肛門跼部切除術治療直腸癌患者的臨床資料,主要採用Cox比例風險模型進行多因素生存預後分析.結果 116例患者術後生存時間為14～160.5箇月,中位生存時間為58.5箇月.總體生存率5年為72%,10年為53%.跼部複髮16例,複髮率為13.8%.單因素分析錶明腫瘤的病理類型、浸潤深度(T分期)、複髮及轉移均為預後影響因素.多因素迴歸分析錶明腫瘤浸潤深度(T分期)、複髮轉移情況是影響生存預後的獨立因素.T_1期直腸癌患者,跼部複髮率為6.3%,5年生存率為93%,10年生存率為85%;T2期直腸癌患者,跼部複髮率為14.8%,5年生存率為63%,10年生存率為45%.T_1期患者接受輔助放療後,無跼部複髮;T_2期患者接受放療後,跼部複髮率為14.6%.接受輔助放療與未接受輔助放療患者的生存預後情況進行比較,通過繪製生存麯線髮現無統計學意義(T_1:P=0.260,T_2:P=0.262).接受輔助放療與未接受輔助放療患者術後跼部腫瘤複髮情況進行比較有統計學意義(P=0.002).結論 經肛門跼部切除術對于T_1期直腸癌治療效果較好,T_2期直腸癌不適閤採用經肛門跼部切除術治療.輔助放療可降低術後直腸癌的跼部複髮率.
목적 탐토경항문국부절제술치료직장암적영향인소급예후.방법 회고성분석1995-2008년116례채용경항문국부절제술치료직장암환자적림상자료,주요채용Cox비례풍험모형진행다인소생존예후분석.결과 116례환자술후생존시간위14～160.5개월,중위생존시간위58.5개월.총체생존솔5년위72%,10년위53%.국부복발16례,복발솔위13.8%.단인소분석표명종류적병리류형、침윤심도(T분기)、복발급전이균위예후영향인소.다인소회귀분석표명종류침윤심도(T분기)、복발전이정황시영향생존예후적독립인소.T_1기직장암환자,국부복발솔위6.3%,5년생존솔위93%,10년생존솔위85%;T2기직장암환자,국부복발솔위14.8%,5년생존솔위63%,10년생존솔위45%.T_1기환자접수보조방료후,무국부복발;T_2기환자접수방료후,국부복발솔위14.6%.접수보조방료여미접수보조방료환자적생존예후정황진행비교,통과회제생존곡선발현무통계학의의(T_1:P=0.260,T_2:P=0.262).접수보조방료여미접수보조방료환자술후국부종류복발정황진행비교유통계학의의(P=0.002).결론 경항문국부절제술대우T_1기직장암치료효과교호,T_2기직장암불괄합채용경항문국부절제술치료.보조방료가강저술후직장암적국부복발솔.
Objective To evaluate the therapeutic effects and prognostic factors of transanal local excision of rectal carcinoma. Methods We retrospectively analyzed 116 cases who underwent transanal lical excision for rectal carcinoma from 1995 to 2008 with the mented of Cox Regression analysis.Result The survival time of all the patients were from 14 to 160.5 months.median time was 58.5 months.Five-year overall survival rate was 72%.ten-year overall survival rate was 53%.There were 16 cases of local recurrence with a rate of 13.8%.In the univariate survival analysis:histopathology,depth of tumor invasion,radiotherapy,recurrence and metastases were the predictors of survival.In the Cox regression analysis:depth of invasion,recurrence and metastases were the independent prognostic taetors for surwval.For T_1 stage,its overall local recurrence rate was 6.3%,five-year overall survival rate was 93%,ten-year overall survival rate Was 85%:For T_2 stage,its overall local recurrence rate was 14.8%,five-year overallsurvival rate Was 63%.ten.year overall survival rate was 45%.For T_1 stage,there Was no local recurrence with radiotherapy:For T_2 stage,local recurrence rate Was 14.6%.From the surivival curve,there Was no difference betwecn the patient accepted radiotherapy or not(T_1:P=0.260,T_2,P=0.262).But for local recurrence,the differences Was significant(P=0.002). Conclusion The result of transanal local excision of rectal carcinoma is satisfactory with T_1 stage,but it is not suitable for T_2 stage tumors.
