内容紹介
Summary
The clinicopathological features of primary small intestinal cancer were assessed retrospectively. Seven patients underwent resection of small bowel cancer in our hospital between June 2011 and January 2019. The mean age of the patients was 62.9 years, and the male to female ratio was 4 :3. Five patients were symptomatic, and the correct preoperative diagnosis rate was 28.6%. The average tumor diameter was 5.3 cm, and the median resected intestine length was 25 cm. Histopathological examination revealed that there were 2 patients with poorly differentiated tumors and 3 patients with pStageⅡA, 3 with pStageⅡB, and 1 with pStage ⅢA disease. Recurrence after surgery occurred in 4 patients, including local recurrence in 2 patients and lymph node recurrence in 1 patient. Median survival was 24.5 months. The resected intestinal length was longer and the mesenteric artery dissection was more extensive in survivors than in dead patients. In contrast, the dead patients were older than the survivors and had undifferentiated tumor, ly2/ly3, lymph node metastasis, and recurrence. Moreover, recurrence occurred in 4 patients who had lymph node metastasis, and/or undifferentiated tumor type, and/or ly2/ly3. An adequate intestinal excision margin along with mesenteric lymph node dissection might be required to improve the survival of patients with primary intestinal cancer.
要旨
2011年6月～2019年1月までに当科で手術を行った原発性小腸癌7例において,臨床病理学的特徴および予後についてretrospectiveに分析した。平均年齢62.9歳,男女比4 :3,有症状5例(71.4%)で,術前正診率28.6%であった。平均腫瘍径5.3 cmで,切除腸管長中央値は25 cmであった。術後病理診断では分化型5例で,pStageⅡA 3例,pStageⅡB 3例,pStage ⅢA 1例であった。再発は4例に認め,再発形式は局所2例,リンパ節1例,肺転移1例で,生存期間中央値は24.5か月であった。生存例では腸管切除長が長く,すべて辺縁動脈を越えた腸間膜リンパ節郭清が施行されていた。一方,死亡例では高齢,未分化,ly2/ly3,N1であり,再発例ではリンパ節転移,低分化,ly2/ly3のいずれかの因子が陽性であった。原発性小腸癌では,十分な切除マージンの確保と腸間膜リンパ節郭清を行うことで予後に寄与する可能性がある。
目次
The clinicopathological features of primary small intestinal cancer were assessed retrospectively. Seven patients underwent resection of small bowel cancer in our hospital between June 2011 and January 2019. The mean age of the patients was 62.9 years, and the male to female ratio was 4 :3. Five patients were symptomatic, and the correct preoperative diagnosis rate was 28.6%. The average tumor diameter was 5.3 cm, and the median resected intestine length was 25 cm. Histopathological examination revealed that there were 2 patients with poorly differentiated tumors and 3 patients with pStageⅡA, 3 with pStageⅡB, and 1 with pStage ⅢA disease. Recurrence after surgery occurred in 4 patients, including local recurrence in 2 patients and lymph node recurrence in 1 patient. Median survival was 24.5 months. The resected intestinal length was longer and the mesenteric artery dissection was more extensive in survivors than in dead patients. In contrast, the dead patients were older than the survivors and had undifferentiated tumor, ly2/ly3, lymph node metastasis, and recurrence. Moreover, recurrence occurred in 4 patients who had lymph node metastasis, and/or undifferentiated tumor type, and/or ly2/ly3. An adequate intestinal excision margin along with mesenteric lymph node dissection might be required to improve the survival of patients with primary intestinal cancer.
要旨
2011年6月～2019年1月までに当科で手術を行った原発性小腸癌7例において,臨床病理学的特徴および予後についてretrospectiveに分析した。平均年齢62.9歳,男女比4 :3,有症状5例(71.4%)で,術前正診率28.6%であった。平均腫瘍径5.3 cmで,切除腸管長中央値は25 cmであった。術後病理診断では分化型5例で,pStageⅡA 3例,pStageⅡB 3例,pStage ⅢA 1例であった。再発は4例に認め,再発形式は局所2例,リンパ節1例,肺転移1例で,生存期間中央値は24.5か月であった。生存例では腸管切除長が長く,すべて辺縁動脈を越えた腸間膜リンパ節郭清が施行されていた。一方,死亡例では高齢,未分化,ly2/ly3,N1であり,再発例ではリンパ節転移,低分化,ly2/ly3のいずれかの因子が陽性であった。原発性小腸癌では,十分な切除マージンの確保と腸間膜リンパ節郭清を行うことで予後に寄与する可能性がある。