内容紹介
Summary
Primary carcinoma of the vermiform appendix is a rare neoplasm, and its treatment strategy has not yet been established. We retrospectively analyzed 8 cases of primary carcinoma of the vermiform appendix from 2007 to 2017. Six cases were male and two were female, with a median age of 60.5 years. Ileocecal resection and right hemicolectomy were performed in 7 cases and 1 case, respectively. Regarding pathological staging, 5 cases were of pStage Ⅱ, 2 were of pStage Ⅲa, and 1 was of pStage Ⅳ. Three cases had recurrences after curative resection. The postoperative median overall survival time was 45 months. Three cases with a tumor diameter of 20 mm were alive without any recurrence; however, 3 of 5 cases with a tumor diameter of >_21 mm had recurrences. Although only 1 of 3 cases with adjuvant chemotherapy(pStage Ⅲa case)had recurrence, 2 of 4 cases without adjuvant chemotherapy, including a pStage Ⅱ case, had recurrences. Early diagnosis, surgery, and adjuvant chemotherapy could improve the long-term outcomes of patients with primary carcinoma of the vermiform appendix.
要旨
原発性虫垂癌は比較的まれな疾患であり,未だ治療法は確立されていない。今回われわれは,原発性虫垂癌の8例を経験したので若干の文献的考察を加えて報告する。対象は2007～2017年までに当院で外科手術を施行した原発性虫垂癌8例である。年齢の中央値は60.5(範囲: 45～82)歳,男性6例,女性は2例であった。結腸右半切除術1例,回盲部切除術が7例に施行され,術後病理組織学的病期はpStage Ⅱ 5例,pStage Ⅲa 2例,pStage Ⅳが1例であった。術後再発を3例に認め,術後全生存期間中央値は45か月であった。病変長径が20 mm以下の3症例は全例無再発生存が得られていたが,病変の長径が21 mm以上の症例は5例中3例に術後再発を認め,1例は腹膜播種を認めpStage Ⅳであった。また,術後補助化学療法を行った症例は3例中pStage Ⅲaの1例が再発し,行わなかった症例は4例中pStage Ⅱを含む2例に再発を認めていた。
目次
Primary carcinoma of the vermiform appendix is a rare neoplasm, and its treatment strategy has not yet been established. We retrospectively analyzed 8 cases of primary carcinoma of the vermiform appendix from 2007 to 2017. Six cases were male and two were female, with a median age of 60.5 years. Ileocecal resection and right hemicolectomy were performed in 7 cases and 1 case, respectively. Regarding pathological staging, 5 cases were of pStage Ⅱ, 2 were of pStage Ⅲa, and 1 was of pStage Ⅳ. Three cases had recurrences after curative resection. The postoperative median overall survival time was 45 months. Three cases with a tumor diameter of 20 mm were alive without any recurrence; however, 3 of 5 cases with a tumor diameter of >_21 mm had recurrences. Although only 1 of 3 cases with adjuvant chemotherapy(pStage Ⅲa case)had recurrence, 2 of 4 cases without adjuvant chemotherapy, including a pStage Ⅱ case, had recurrences. Early diagnosis, surgery, and adjuvant chemotherapy could improve the long-term outcomes of patients with primary carcinoma of the vermiform appendix.
要旨
原発性虫垂癌は比較的まれな疾患であり,未だ治療法は確立されていない。今回われわれは,原発性虫垂癌の8例を経験したので若干の文献的考察を加えて報告する。対象は2007～2017年までに当院で外科手術を施行した原発性虫垂癌8例である。年齢の中央値は60.5(範囲: 45～82)歳,男性6例,女性は2例であった。結腸右半切除術1例,回盲部切除術が7例に施行され,術後病理組織学的病期はpStage Ⅱ 5例,pStage Ⅲa 2例,pStage Ⅳが1例であった。術後再発を3例に認め,術後全生存期間中央値は45か月であった。病変長径が20 mm以下の3症例は全例無再発生存が得られていたが,病変の長径が21 mm以上の症例は5例中3例に術後再発を認め,1例は腹膜播種を認めpStage Ⅳであった。また,術後補助化学療法を行った症例は3例中pStage Ⅲaの1例が再発し,行わなかった症例は4例中pStage Ⅱを含む2例に再発を認めていた。