肉眼的周囲臓器浸潤を認めた大腸癌切除症例の検討 Clinicopathological Analysis of Colorectal Cancer with Combined Resection of Adjacent Organs

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(目的)肉眼的周囲臓器浸潤を認めた大腸癌症例における,周囲臓器合併切除の意義について検討した.(対象と方法)1983年から1999年までに当科で切除された大腸癌557例のうち,Si.Ai大腸癌66例(12%)を対象として,臨床病理学的因子,予後について検討した.(結果)66例中55例(83%)に他臓器合併切除が施行され,組織学的根治度は根治度A27例,B8例,C31例であった.58例で病理組織学的検討が可能で,組織学的にsi.aiが確認された症例は33例37臓器(57%)であった.Si.Ai症例は占居部位では横行結腸と盲腸,組織型では低分化腺癌に多く,またリンパ節転移率は有意に高値であった.全症例の5年生存率は34%で,根治度別には根治度A61%,B19%,CO%であった.根治度A,B症例において,リンパ節転移陰性例は陽性例に比して有意に予後良好であったが,si.ai症例とse.a2以浅症例の間には,予後に差を認めなかった.(結語)根治度B以上が期待できれば,積極的な合併切除が治療成績の向上につながると考えられた.

Clinicopathological characteristics and prognosis of 66 patients with primary colorectal cancer with macroscopic invasion into the adjacent organs were evaluated. The patients were operated on at our hospital from 1983 to 1999. Fifty-five of the 66 patients underwent combined resection of colorectal tumor and the adjacent organs, resulting in curative resection in 35 patients. The invasion was frequently seen in the peritoneum, urinary bladder and small intestine. These were predominantly located in the transverse colon and cecum, and were predominantly poorly-differentiated adenocarcinoma and had a significantly higher incidence of lymph node metastasis. However, only 33/58 (57%) cases were verified microscopically to have invasion. The five-year survival rate in all cases was 34 %, and according to the curability, that of A was 61 %, B was 19%, and C was 0%. The five-year survival rate of patients with positive lymph node metastases was significantly worse than that of negative ones in the surgically curative cases. No significant difference in prognosis between patients with direct invasion and those without such invasion was found. The results indicate that combined resection of the adjacent organs may enhance prognosis in colorectal cancer, if it is suspected to have direct invasion in possibly surgically curative cases.

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 55(4), 195-199, 2002-04-01

    日本大腸肛門病学会

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各種コード

  • NII論文ID(NAID)
    10008582333
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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