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目的探讨复发性结直肠癌的临床病理特征和预后。方法对进行根治性切除的993例结直肠癌患者中235例复发患者的临床资料进行总结,并分析术后复发的影响因素。结果根治术后全组总体5、10年生存率分别为67．7%和55．8%；术后复发组则分别为43．9%和28．1%；差异有统计学意义(P＜0．001)。复发组患者中,再次行根治性切除者的5、10年生存率分别为50．2%和32．7%；而予以姑息手术或保守治疗者则分别为25．8%和0；差异亦有统计学意义(P＜0．001)。单因素分析显示,复发的结直肠癌患者年龄、癌性肠梗阻和腹水、淋巴结转移及肿瘤大体分型、侵袭程度及病理分期与术后复发密切相关；而多因素分析则显示,癌性肠梗阻和腹水、肿瘤大体分型及病理分期与术后复发和转移密切相关。结论根治术后结直肠癌患者的复发和转移与癌性肠梗阻和腹水及肿瘤病理分期密切相关；再次手术切除可以提高复发转移患者的生存率。
Objective To investigate the clinicopathological characteristics and prognosis of recurrent colorectal cancer. Methods The clinical data of 235 patients with recurrent colorectal cancer who underwent radical resection were retrospectively analyzed. The influencing factors of postoperative recurrence were analyzed. Results The overall 5-year and 10-year survival rates were 67.7% and 55.8% respectively in the whole group and 43.9% and 28.1% in the postoperative recurrence group, respectively, with significant difference (P < 0.001). In the recurrent group, the 5-year and 10-year survival rates of those who underwent radical resection were 50.2% and 32.7% respectively, while those who were treated for palliative or conservative treatment were 25.8% and 0 respectively. The differences were also significant There was statistical significance (P <0.001). Univariate analysis showed that age, cancerous intestinal obstruction and ascites, lymph node metastasis and gross tumor classification, invasion and pathological stage of recurrent colorectal cancer patients were closely related to postoperative recurrence; and multivariate analysis showed that cancerous intestinal Obstruction and ascites, gross tumor classification and pathological stage and recurrence and metastasis are closely related. Conclusions The recurrence and metastasis of patients with colorectal cancer after radical operation are closely related to the pathological stage of cancerous ileus and ascites and tumor. Reoperation can improve the survival rate of patients with recurrence and metastasis.