ANALYSIS OF LOCAL RECURRENCE RATES AFTER SURGERY ALONE FOR RECTAL-CANCER

被引：299

作者：

MCCALL, JL

COX, MR

WATTCHOW, DA

机构：

[1] Gastrointestinal Surgical Unit, Flinders Medical Centre, Bedford Park, 5042, South Australia

来源：

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE | 1995年 / 10卷 / 03期

关键词：

D O I：

10.1007/BF00298532

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Local recurrence (LR) continues to be a major problem following surgical treatment for rectal cancer, and proposed ways of reducing this remain controversial The aim of this study was to review results from published surgical series in which adjuvant therapies were not used. A Medline search identified series published between January 1982 and December 1992 with follow-up on at least 50 patients with rectal cancer treated surgically for cure, without adjuvant therapy. Fifty one papers reported follow-up on 10,465 patients with a median LR rate of 18.5%. LR was 8.5%, 16.3% and 28.6% in Dukes' A, B and C patients respectively, 16.2% following anterior resection and 19.3% following abdominoperineal resection. Nine papers (1,176 patients) reported LR rates of 10% or less. LR was 7.1% in 1,033 patients having total mesorectal excision and 12.4% in 476 patients having extended pelvic lymphadenectomy. Routine cytocidal stump washout in 1,364 patients was associated with 12.2% LR, however a higher proportion (41%) also underwent total mesorectal excision. In 52% of cases, LR was reported to have occurred with no evidence of disseminated disease. Surgical technique is an important determinant of LR risk. LR rates of 10% or less can be achieved with surgery alone in expert hands.

引用

页码：126 / 132

页数：7

共 103 条

[11] Pilipshen S.J., Heilweil M., Quan H.Q., Sternberg S.S., Enker W.E., Patterns of pelvic recurrence following definitive resections of rectal cancer, Cancer, 53, pp. 1354-1362, (1984)
[12] Cohen A.M., Minsky B.D., Aggressive surgical management of locally advanced primary and recurrent rectal cancer, Dis Colon Rectum, 33, pp. 432-438, (1990)
[13] Gilbert J.M., Jeffrey I., Evans M., Kark A.E., Sites of recurrent tumour after ‘curative’ colorectal surgery: implications for adjuvant therapy, Br J Surg, 71, pp. 203-205, (1984)
[14] Heald R.J., Ryall R.D.H., The mesorectum in rectal cancer surgery — the clue to pelvic recurrence?, Br J Surg, 69, pp. 613-616, (1982)
[15] Hojo K., Sawada T., Moriya Y., An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy, Dis Colon Rectum, 32, pp. 128-133, (1989)
[16] Enker W.E., Pilipshen S.J., Heilweil M.L., Et al., En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer, Ann Surg, 203, pp. 426-433, (1986)
[17] Yasutomi M., Shindo K., Mori N., Matsuda T., Does the pelvic nodes dissection for the rectal cancer patients make any contribution to the end-results of surgery?, Gan To Kagaku Ryoho, 18, pp. 541-546, (1991)
[18] Glass R.E., Ritchie J.K., Thompson H.R., Mann C.V., The results of surgical treatment of cancer of the rectum by radical resection and extended abdomino-ilaic lymphadenectomy, Br J Surg, 72, pp. 599-601, (1985)
[19] Michelassi F., Block G.E., Vannucei L., Montag A., Chappell R., A 5- to 21-year follow-up and analysis of 250 patients with rectal adenocarcinoma, Ann Surg, 208, pp. 379-389, (1988)
[20] Umpleby H.C., Williaon R.C.N., Anastomotic recurrence in large bowel cancer, Br J Surg, 74, pp. 873-878, (1987)

← 1 2 3 4 5 6 7 8 9 10 →