内容紹介
Multiple Resections for Metastases from Colorectal Cancer
Summary
Purpose: We analyzed to clarify an outcome of multiple resections of metastases from colorectal cancer. Patients and method: Total 7 cases who underwent several resections for metastases from colorectal cancer in Saiseikai Kurihashi Hospital after 2010 were enrolled for analysis. Result: Age of patients at the time of the primary site resection was 67(45-78)year-old, including 4 males and 3 females. Patients located at cecum/ascending/sigmoid/rectosigmoid/upper rectum were 1/1/2/2/1 respectively. Metachronous metastases were found in 5 patients. There were 1 patient for StageⅠ, 2 patients for StageⅢa and Ⅲb each and all StageⅢ patients received adjuvant chemotherapy. The resected organs were 9 in lung, 8 in liver, 1 case in lymph node, local site and peritoneum and the median resected sites were 3(2-4)lesions. In 17 months median observation periods after latest resection, 5 cases have not been prolapsed including 3 cases with chemotherapy. Two cases were relapsed with unresectble status. One case died for 24 months and one case is under the chemotherapy for 12 months. Five year survival rate was 75% and 2 year prolapse free rate was 66.7%, since the relatively good prognosis was obtained by multiple resections. Conclusion: The cases that multiple resections with R0 were able to perform for the metastases were analyzed. Although cases which become finally to be unresectable exist, it is suggested that the relatively good prognosis might be obtained by multiple resections for metastases.
要旨
目的: 複数回の転移巣切除を施行した大腸癌の治療成績を明らかにすることを目的に検討した。対象・方法: 対象は2010年以降,済生会栗橋病院外科で大腸癌の再発転移巣切除を複数回施行された大腸癌の7例で,臨床経過について解析した。結果: 対象の原発巣切除時の年齢中央値は67(45～78)歳で,男性4例,女性3例,原発部位は盲腸,上行結腸各1例,S状結腸,直腸S状部各2例,上部直腸1例であった。異時性転移が5例で原発巣切除時のStageⅠ 1例,StageⅢa 2例,StageⅢb 2例,StageⅢ症例には補助化学療法が施行されていた。切除対象部位は肺9病巣,肝8病巣,リンパ節,局所,腹膜が各1病巣であり,切除転移部位数の中央値は3(2～4)病巣であった。最終転移巣切除からの観察期間中央値17か月で無再発は5例で,うち3例に化学療法が施行された。再発は2例で,2例とも切除不能再発で,1例は化学療法後24か月で原癌死,1例は化学療法施行中(12か月)である。7例の原発巣切除からの5年生存率は75%,最終切除からの2年生存率は66.7%であり,複数回の切除で比較的良好な予後が得られた。結語: R0切除可能な再発転移巣に対し,複数回の手術を施行した症例について検討した。最終的に切除不能再発となる症例が存在するが,転移巣切除により比較的良好な予後が得られる可能性が示唆される。
目次
Summary
Purpose: We analyzed to clarify an outcome of multiple resections of metastases from colorectal cancer. Patients and method: Total 7 cases who underwent several resections for metastases from colorectal cancer in Saiseikai Kurihashi Hospital after 2010 were enrolled for analysis. Result: Age of patients at the time of the primary site resection was 67(45-78)year-old, including 4 males and 3 females. Patients located at cecum/ascending/sigmoid/rectosigmoid/upper rectum were 1/1/2/2/1 respectively. Metachronous metastases were found in 5 patients. There were 1 patient for StageⅠ, 2 patients for StageⅢa and Ⅲb each and all StageⅢ patients received adjuvant chemotherapy. The resected organs were 9 in lung, 8 in liver, 1 case in lymph node, local site and peritoneum and the median resected sites were 3(2-4)lesions. In 17 months median observation periods after latest resection, 5 cases have not been prolapsed including 3 cases with chemotherapy. Two cases were relapsed with unresectble status. One case died for 24 months and one case is under the chemotherapy for 12 months. Five year survival rate was 75% and 2 year prolapse free rate was 66.7%, since the relatively good prognosis was obtained by multiple resections. Conclusion: The cases that multiple resections with R0 were able to perform for the metastases were analyzed. Although cases which become finally to be unresectable exist, it is suggested that the relatively good prognosis might be obtained by multiple resections for metastases.
要旨
目的: 複数回の転移巣切除を施行した大腸癌の治療成績を明らかにすることを目的に検討した。対象・方法: 対象は2010年以降,済生会栗橋病院外科で大腸癌の再発転移巣切除を複数回施行された大腸癌の7例で,臨床経過について解析した。結果: 対象の原発巣切除時の年齢中央値は67(45～78)歳で,男性4例,女性3例,原発部位は盲腸,上行結腸各1例,S状結腸,直腸S状部各2例,上部直腸1例であった。異時性転移が5例で原発巣切除時のStageⅠ 1例,StageⅢa 2例,StageⅢb 2例,StageⅢ症例には補助化学療法が施行されていた。切除対象部位は肺9病巣,肝8病巣,リンパ節,局所,腹膜が各1病巣であり,切除転移部位数の中央値は3(2～4)病巣であった。最終転移巣切除からの観察期間中央値17か月で無再発は5例で,うち3例に化学療法が施行された。再発は2例で,2例とも切除不能再発で,1例は化学療法後24か月で原癌死,1例は化学療法施行中(12か月)である。7例の原発巣切除からの5年生存率は75%,最終切除からの2年生存率は66.7%であり,複数回の切除で比較的良好な予後が得られた。結語: R0切除可能な再発転移巣に対し,複数回の手術を施行した症例について検討した。最終的に切除不能再発となる症例が存在するが,転移巣切除により比較的良好な予後が得られる可能性が示唆される。