结直肠肛门外科2025，Vol.31Issue(2)：138-140,3.DOI:10.19668/j.cnki.issn1674-0491.2025.02.009
[评论]梗阻性结肠癌术后异时性腹膜转移的风险评估:基于1085例患者的多因素分析
Risk of metachronous peritoneal metastases after surgery for ob-structive colon cancer:multivariate analysis from a series of 1,085 patients
俞亮 1黄胜辉1
作者信息
- 1. 福建医科大学附属协和医院结直肠外科 福建 福州 350001
- 折叠
摘要
Abstract
Background Data in the literature suggest that obstruction is an independent predictor of poor prognosis in colon cancer.Of all possible sites of recurrence,peritoneal metastases are associated with worse survival.Our aim was to report the incidence of metachronous peritoneal metastases from a cohort of patients undergoing resection of obstruc-tive colon cancer with curative intent and to identify predictive factors for metachronous peritoneal metastases.Methods From 2000 to 2015,a total of 2,325 patients were treated for obstructive colon cancer in French surgical centers,mem-bers of the French National Surgical Association(AFC).Patients with palliative management,synchronous metastatic dis-ease,and with postoperative mortality were excluded.A multivariate analysis was performed to determine independent predictive factors of metachronous peritoneal metastases.Results The cohort included 1,085 patients.The median follow-up was 21.5 months.Metachronous peritoneal metastases occurred in 12％of patients and were diagnosed after a me-dian interval of 13.5 months.The cumulative 3-year metachronous peritoneal metastasis rate was 10.9％.Three-year over-all survival was 85％for patients who did not develop recurrence,71％for those who develop recurrence without perito-neal metastases,and 56％for those with metachronous peritoneal metastases(P＜0.001).In multivariate analysis,3 vari-ables were identified as independent risk factors for metachronous peritoneal metastases:pT4 stage(odds ratio:1.98;95％confidence interval:1.17-3.36;P=0.011),pN2 stage(odds ratio:2.57;95％confidence interval:1.89-4.45;P＜0.001),and fewer than 12 lymph nodes examined(odds ratio:2.01;95％confidence interval:1.08-3.74;P=0.028).Conclusion This study showed a significant risk of metachronous peritoneal metastases after curative-intent resection of obstructive colon cancer.The awareness of factors predisposing to metachronous peritoneal metastases could improve the treatment strategy of these patients.关键词
梗阻性结肠癌/腹膜转移/预后因素Key words
obstructive colon cancer/peritoneal metastases/prognostic factors分类
临床医学引用本文复制引用
俞亮,黄胜辉..[评论]梗阻性结肠癌术后异时性腹膜转移的风险评估:基于1085例患者的多因素分析[J].结直肠肛门外科,2025,31(2):138-140,3.
