文章：

局部复发直肠癌伴已知寡转移疾病的再次盆腔手术联合转移灶切除术：一项多中心回顾性研究

Redo Pelvic Surgery and Combined Metastectomy for Locally Recurrent Rectal Cancer with Known Oligometastatic Disease: A Multicentre Review

原文发布日期：8 September 2023

DOI: 10.3390/cancers15184469

类型: Article

开放获取: 是

英文摘要：

Introduction: Historically, surgical resection for patients with locally recurrent rectal cancer (LRRC) had been reserved for those without metastatic disease. ‘Selective’ patients with limited oligometastatic disease (OMD) (involving the liver and/or lung) are now increasingly being considered for resection, with favourable five-year survival rates. Methods: A retrospective analysis of consecutive patients undergoing multi-visceral pelvic resection of LRRC with their oligometastatic disease between 1 January 2015 and 31 August 2021 across four centres worldwide was performed. The data collected included disease characteristics, neoadjuvant therapy details, perioperative and oncological outcomes. Results: Fourteen participants with a mean age of 59 years were included. There was a female preponderance (n = 9). Nine patients had liver metastases, four had lung metastases and one had both lung and liver disease. The mean number of metastatic tumours was 1.5 +/− 0.85. R0 margins were obtained in 71.4% (n = 10) and 100% (n = 14) of pelvic exenteration and oligometastatic disease surgeries, respectively. Mean lymph node yield was 11.6 +/− 6.9 nodes, with positive nodes being found in 28.6% (n = 4) of cases. A single major morbidity was reported, with no perioperative deaths. At follow-up, the median disease-free survival and overall survival were 12.3 months (IQR 4.5–17.5 months) and 25.9 months (IQR 6.2–39.7 months), respectively. Conclusions: Performing radical multi-visceral surgery for LRRC and distant oligometastatic disease appears to be feasible in appropriately selected patients that underwent good perioperative counselling.

摘要翻译： 

引言：历史上，局部复发性直肠癌（LRRC）的手术切除仅适用于无远处转移的患者。目前，对于具有有限寡转移性疾病（OMD）（累及肝脏和/或肺部）的“选择性”患者，越来越多地考虑进行手术切除，并显示出良好的五年生存率。方法：对2015年1月1日至2021年8月31日期间，在全球四个中心连续接受LRRC多脏器盆腔切除术并伴有寡转移性疾病的患者进行回顾性分析。收集的数据包括疾病特征、新辅助治疗细节、围手术期及肿瘤学结果。结果：共纳入14名参与者，平均年龄59岁。女性占多数（n=9）。9名患者有肝转移，4名有肺转移，1名同时有肺和肝转移。转移性肿瘤的平均数量为1.5 ± 0.85个。在盆腔廓清术和寡转移性疾病手术中，分别有71.4%（n=10）和100%（n=14）的患者获得了R0切缘。平均淋巴结检出数量为11.6 ± 6.9个，其中28.6%（n=4）的病例发现淋巴结阳性。报告了一例主要并发症，无围手术期死亡。随访期间，中位无病生存期和总生存期分别为12.3个月（IQR 4.5–17.5个月）和25.9个月（IQR 6.2–39.7个月）。结论：对于经过适当选择并接受了良好围手术期咨询的患者，对LRRC及远处寡转移性疾病进行根治性多脏器手术似乎是可行的。

原文链接：

Redo Pelvic Surgery and Combined Metastectomy for Locally Recurrent Rectal Cancer with Known Oligometastatic Disease: A Multicentre Review