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背景与目的:多原发大肠癌在大肠癌中并非少见,但其生物学行为较独特。本研究探讨多原发大肠癌(MPCC)的临床特点、诊断、外科治疗及预后。方法:对1997～2003年间手术治疗的70例MPCC患者的临床资料进行回顾性研究,其中同时性多原发大肠癌(SC)61例,异时性多原发大肠癌(MC)9例,并结合随访资料进行生存分析。结果:55例患者术前经肠镜、钡灌肠或CT诊断,15例患者因远端肿瘤过大无法进镜于术中诊断。70例患者中伴发结肠多发腺瘤性息肉者33例。除3例患者肿瘤广泛播散仅行短路手术外,其余均同期手术切除。其中根治性切除52例,姑息性切除15例。总的3年和5年生存率分别为65.7%和45.7%,其中根治性切除患者的3年和5年生存率分别为78.1%和59.3%。结论:MPCC的发生过程与腺瘤及息肉关系密切。其手术治疗并无固定模式,需根据肿瘤的位置、范围、间距以及患者的综合情况等决定。MPCC总体预后较好。应着重随访伴发腺瘤及息肉的MPCC患者。
Background and Objective: Multiple primary colorectal cancer is not uncommon in colorectal cancer, but its biological behavior is rather unique. This study was to explore the clinical features, diagnosis, surgical treatment and prognosis of multiple primary colorectal cancer (MPCC). Methods: The clinical data of 70 patients with MPCC surgically treated from 1997 to 2003 were retrospectively studied. Among them, 61 cases were simultaneously diagnosed as multiple primary colorectal cancer (SC), 9 cases were multi-primary colorectal cancer (MC) Combined with follow-up data for survival analysis. Results: Fifty-five patients were diagnosed preoperatively by colonoscopy, barium enema or CT. Fifteen patients were diagnosed by intra-operative because of the large distal tumor. Thirty-three patients with colorectal adenomatous polyps were found in 70 patients. In addition to 3 patients with extensive dissemination of tumor only short-circuit surgery, the rest were surgery at the same time. Of which radical resection in 52 cases, palliative resection in 15 cases. The overall 3-year and 5-year overall survival rates were 65.7% and 45.7%, respectively. The 3-year and 5-year survival rates of radical resections were 78.1% and 59.3%, respectively. Conclusion: The occurrence of MPCC is closely related to adenoma and polyp. There is no fixed mode of surgical treatment, according to the tumor’s location, scope, spacing and the patient’s overall situation and so decided. The overall prognosis of MPCC is better. Should focus on follow-up with adenomas and polyps in patients with MPCC.