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Management of recurrent rectal cancer:A population based study in greater Amsterdam

查看全文 作　　者：Roel [1]Bakx;Otto [2]Visser;Judith [2]Josso;Sybren [3]Meijer;J Frederik M [1]Slors;J Jan B van [1,4]Lanschot 高影响力作者 机构地区：[1]Department of Surgery,Academic Medical Centre,Amsterdam AZ 1105,Netherlands;[2]Comprehensive Cancer Centre Amsterdam,Amsterdam CX 1066,Netherlands;[3]Department of Surgery,Free University Medical Centre,Amsterdam HV 1081,Netherlands;[4]Presently at the Erasmus Medical Center,Rotterdam CE 3015,Netherlands高影响力机构 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第39期,共6页高影响力期刊 摘　　要：AIM: To analyze,retrospectively in a population-based study,the management and survival of patients with recurrent rectal cancer initially treated with a macroscopically radical resection obtained with total mesorectal excision (TME). METHODS: All rectal carcinomas diagnosed during 1998 to 2000 and initially treated with a macroscopically radical resection (632 patients) were selected from the Amsterdam Cancer Registry. For patients with recurrent disease,information on treatment of the recurrence was collected from the medical records. RESULTS: Local recurrence with or without clinically apparent distant dissemination occurred in 62 patients (10%). Thirty-two patients had an isolated local recurrence. Ten of these 32 patients (31%) underwent radical re-resection and experienced the highest survival (three quarters survived for at least 3 years). Eight patients (25%) underwent non-radical surgery (median survival 24 mo),seven patients (22%) were treated with radio-and/or chemotherapy without surgery (median survival 15 mo) and seven patients (22%) only received best supportive care (median survival 5 mo). Distant dissemination occurred in 124 patients (20%) of whom 30 patients also had a local recurrence. The majority (54%) of these patients were treated with radio-and/or chemotherapy without surgery (median survival 15 mo). Twenty-seven percent of these patients only received best supportive care (median survival 6 mo),while 16% underwent surgery for their recurrence. Survival was best in the latter group (median survival 32 mo). CONCLUSION: Although treatment options and survival are limited in case of recurrent rectal cancer after radical local resection obtained with TME,patients can benefit from additional treatment,especially if a radical resection is feasible. 关 键 词：直肠癌 病理机制 治疗方法 疾病调查
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