[评论]手术切除对结直肠癌卵巢转移的影响及临床病理特征分析:来自日本的多中心回顾性研究
Impact of resection for ovarian metastases from colorectal can-cer and clinicopathologic analysis:a multicenter retrospective study in Japan
KAGAWA H KINUGASA Y YAMAGUCHI T 林羽 1黄胜辉1
作者信息
- 1. 福建医科大学附属协和医院结直肠外科 福建福州 350001
- 折叠
摘要
目的 本研究旨在阐明手术切除对结直肠癌卵巢转移的意义并分析临床病理特征.方法 在这项多中心回顾性研究中,研究人员收集并评估来自日本的20个医疗中心自2000年至2014年的结直肠癌卵巢转移患者的数据,旨在探讨手术切除卵巢转移灶对患者预后的影响,并探究预后因素.结果 该研究纳入了296例卵巢转移患者.孤立性卵巢转移患者的3年总生存率为68.6%.在该队列的所有病例中,卵巢转移灶根治性切除、非根治性切除和未切除的患者的3年总生存率分别为65.9%、31.8%和6.1%(根治性切除 vs.非根治性切除,P＜0.01;非根治性切除 vs.未切除,P＜0.01).关于预后因素的多因素分析模型结果显示,卵巢转移灶大小(P＜0.01)、双侧卵巢转移(P=0.01)、腹膜转移(P＜0.01)、肺转移(P=0.04)、肝转移(P＜0.01)、卵巢转移灶残留(P＜0.01)是影响预后的关键因素.结论 在Ⅳ期结直肠癌患者中,接受根治性手术切除的孤立性卵巢转移患者的预后相对较好.无论是实施了根治性切除还是非根治性切除,手术切除卵巢转移灶均能带来生存获益.影响预后的关键因素主要包括大的卵巢转移灶、双侧卵巢转移、存在卵巢外转移和卵巢转移灶残留.
Abstract
Aim The aim of this study was to clarify the significance of resection of ovarian metastases from colorectal cancer and to identify the clinicopathologic characteristics.Methods In this multicenter retrospective study,we evaluated data on ovarian metastases from colorectal cancer obtained from patients at 20 centers in Japan between 2000 and 2014.We examined the impact of resection on the prognosis of patients with ovarian metastases and examined prognos-tic factors.Results The study included 296 patients with ovarian metastasis.The 3-y overall survival rate was 68.6%for solitary ovarian metastases.In all cases of this cohort,the 3-y overall survival rates after curative resection,noncu-rative resection,and nonresection were 65.9%,31.8%,and 6.1%,respectively(curative resection vs.noncurative resection[P＜0.01]and noncurative resection vs.nonresection[P＜0.01]).In the multivariate analysis of prognostic factors,tumor size of ovarian metastasis(P＜0.01),bilateral ovarian metastasis(P=0.01),peritoneal metastasis(P＜0.01),pulmonary metastasis(P=0.04),liver metastasis(P＜0.01),and remnant of ovarian metastasis(P＜0.01)were statistically signifi-cantly different.Conclusion The prognosis after curative resection for solitary ovarian metastases was shown to be rela-tively favorable as Stage IV colorectal cancer.Resection of ovarian metastases,not only curative resection but also noncu-rative resection,confers a survival benefit.Prognostic factors were large ovarian metastases,bilateral ovarian metastases,the presence of extraovarian metastases,and remnant ovarian metastases.
关键词
结直肠癌/卵巢转移/卵巢切除术/腹膜转移/预后因素Key words
colorectal cancer/ovarian metastasis/ovarian resection/peritoneal metastasis/prognostic factor引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据