内容紹介
Summary
We assessed the therapeutic effect of curative resection in patients with multiple relapses of colorectal cancer using the time to surgical failure(TSF)as an index. We included 24 patients who experienced recurrence after curative resection of primary colorectal cancer at our department between 1993 and 2015. Curative resection for multiple relapses was possible in these patients. The sites of recurrence included the liver, lungs, peritoneum, lymph nodes, localized, and brain in 9, 8, 3, 3, 2, and 1 patients, respectively. The relapse occurred in 2 organs in 2 patients. The TSF after curative resection of recurrent lesions was 25.6 months, with a 5-year TSF-free rate of 40.2%. The clinicopathological factors associated with poor prognosis were age >_65 years at the time of recurrence, absence of distal metastasis at primary onset, and only 2 curative resections for relapses. However, there was no difference in prognosis because of the number of twice recurrent lesions. Therefore, curative resection should be proactively performed as long as feasible in colorectal cancer patients with multiple lesions or multiple relapses.
要旨
大腸癌の複数回再発例に対する治癒切除の意義をみるため,time to surgical failure(TSF)を指標に治療効果を検討した。1993～2015年までに当科で加療した初発大腸癌治癒切除後の再発例のうち,複数回の再発に対し治癒切除が可能であった24例を対象とした。再々発部位は肝9例,肺8例,腹膜3例,リンパ節3例,局所2例,脳1例で,うち2例は2臓器への再発であった。再々発巣治癒切除後のTSF期間25.6か月,5年TSF free率は40.2%であった。臨床病理学的因子との関連では再々発時の年齢が65歳以上,初発時に遠隔転移なし,再発治癒切除の回数が2回のみで予後が不良であった。一方,再々発の病巣数では予後に有意差はなかった。大腸癌複数回再発例では治癒切除可能であれば,多発例や複数回の再発例でも積極的に切除すべきと考えられた。
目次
We assessed the therapeutic effect of curative resection in patients with multiple relapses of colorectal cancer using the time to surgical failure(TSF)as an index. We included 24 patients who experienced recurrence after curative resection of primary colorectal cancer at our department between 1993 and 2015. Curative resection for multiple relapses was possible in these patients. The sites of recurrence included the liver, lungs, peritoneum, lymph nodes, localized, and brain in 9, 8, 3, 3, 2, and 1 patients, respectively. The relapse occurred in 2 organs in 2 patients. The TSF after curative resection of recurrent lesions was 25.6 months, with a 5-year TSF-free rate of 40.2%. The clinicopathological factors associated with poor prognosis were age >_65 years at the time of recurrence, absence of distal metastasis at primary onset, and only 2 curative resections for relapses. However, there was no difference in prognosis because of the number of twice recurrent lesions. Therefore, curative resection should be proactively performed as long as feasible in colorectal cancer patients with multiple lesions or multiple relapses.
要旨
大腸癌の複数回再発例に対する治癒切除の意義をみるため,time to surgical failure(TSF)を指標に治療効果を検討した。1993～2015年までに当科で加療した初発大腸癌治癒切除後の再発例のうち,複数回の再発に対し治癒切除が可能であった24例を対象とした。再々発部位は肝9例,肺8例,腹膜3例,リンパ節3例,局所2例,脳1例で,うち2例は2臓器への再発であった。再々発巣治癒切除後のTSF期間25.6か月,5年TSF free率は40.2%であった。臨床病理学的因子との関連では再々発時の年齢が65歳以上,初発時に遠隔転移なし,再発治癒切除の回数が2回のみで予後が不良であった。一方,再々発の病巣数では予後に有意差はなかった。大腸癌複数回再発例では治癒切除可能であれば,多発例や複数回の再発例でも積極的に切除すべきと考えられた。