他臓器の癌を重複した大腸癌症例の検討 : 重複癌が大腸癌の治療成績に及ぼす影響について  [in Japanese] A CLINICAL STUDY OF COLORECTAL CANCER WITH OTHER PRIMARY CARCINOMA  [in Japanese]

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Abstract

1986年1月から1997年12月までの12年間に,根治度Aの切除を施行した428例を対象として,他臓器重複癌が,大腸癌治癒切除例の治療成績に及ぼす影響および経過観察における留意点について検討した.重複癌は, 67例 (15.6%) で,臓器別にみると,胃36例 (53.7%),肺9例 (13.4%),膵胆道系6例 (9.0%) などであった.重複の有無別治療成績は,非重複例が有意に良好であったが,多変量解析の結果,重複癌が予後に関与するリスク比は,リンパ節転移程度,壁深達度に比較し低かった.他癌死例の分析では,重複癌の中で最も高頻度の胃癌による死亡は, 3例 (8.3%) と少なく,膵胆道系 (83.3%), 肺 (44.4%) の死亡率が高かった.重複癌,特に,胃癌に対する診断治療の適切さは示唆されたが,膵胆道系,肺の治療成績は不良で,大腸癌の治療過程においても,これらの大腸癌の早期診断に留意することが重要と考えた.

A total of 428 consecutive colorectal cencer with other primary carcinoma undergoing curative resection between January 1986 and December 1997 were subjected to the present study, in order to clarify whether other primary carcinoma affected the prognosis of curatively resected colorectal cancer. And what was of prime importance in postoperative surveillance was also investigated. Sixty-seven out of 428 patients had other primary carcinoma (15.6%). As for other organs affected, the stomach was the most common (53.7%). followed by the lung(13.4%) and biliary tract (9.0%). There was a significant difference between the patients with and without other primary carcinoma in the 10-year survival rate (p=0.0107). On a multivariate analysis, lymph node metastasis and depth of invasion of tumor were more significant factors than the presence of othre primary carcinoma. In an analysis of the cause of death, the incidence of patients died of gastric cancer was as low as 8.3%. On the other hand, in cancer of the biliary tract and lung cancer respectively, higher incidences of 83.3% and 44.4% were noted. It is suggested that the diagnosis and treatment for other primary carcinoma, especially gastric cancer, are appropriate, however, therapeutic outcomes for biliary and lung cancer are poor. We must remain alert for making early diagnosis of other primary carcinoma, especially biliary and lung cancer, in postoperative surveillance of colorectal center.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 62(4), 874-878, 2001-04-25

    Japan Surgical Association

References:  26

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008389265
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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