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目的 pT1-2N0M0期中上段直肠癌复发风险低,无瘤生存率和总生存率均高于90%。本研究回顾性分析pT1-2N0M0期中上段直肠癌根治术后病例的临床病理特征与远期疗效的关系。方法 2008年1月至2013年12月间,接受根治性全直肠系膜切除术(total mesorectal excision,TME)并经病理学证实为T1-2N0中上段直肠腺癌患者共292例。对无局部复发生存、无远处转移生存、无瘤生存和总生存率进行了评价,并应用单因素和多因素分析的方法分析影响上述远期预后指标的临床病理因素。结果全组病例中位随访时间为54个月。5年的无局部复发生存率、无远处转移生存率、无瘤生存率和总生存率分别为98.8%,90.4%,91.1%和94.2%。单因素分析显示,清扫小于13枚淋巴结是无远处转移生存和无瘤生存的影响因素(P=0.036,0.049)。结论中上段直肠癌TME术后Ⅰ期患者可以达到良好的长期结果。淋巴结清扫数目可作为判断直肠癌患者预后的参考指标。
The purpose of pT1-2N0M0 middle and upper rectal cancer recurrence risk is low, tumor-free survival and overall survival were higher than 90%. This study retrospectively analyzed the relationship between the clinicopathological characteristics of long-term and long-term results of patients with rectal cancer after radical resection of pT1-2N0M0. Methods From January 2008 to December 2013, 292 patients with radical rectal adenocarcinoma undergoing radical total mesorectal excision (TME) and confirmed by pathology were T1-2N0. No recurrence, distant metastasis-free survival, tumor-free survival and overall survival were evaluated, and univariate and multivariate analysis methods were used to analyze the clinical and pathological factors that affect the long-term prognosis. Results The median follow-up time was 54 months in all cases. Five years of no local recurrence, no distant metastasis, tumor-free survival and overall survival were 98.8%, 90.4%, 91.1% and 94.2%, respectively. Univariate analysis showed that clearance of less than 13 lymph nodes was the influencing factor for distant metastasis-free and tumor-free survival (P = 0.036,0.049). Conclusions Mid-upper rectal cancer patients with stage I TME can achieve good long-term results. The number of lymph node dissection can be used as a reference to determine the prognosis of patients with rectal cancer.