摘要
目的了解肛管直肠恶性黑色素瘤的生物学特性和根治性外科手术在治疗该病中的临床意义。方法回顾性总结自１９６５年至１９９５年在我院接受治疗的肛管直肠恶性黑色素瘤患者２９例的临床和病理资料。结果本组女１９例，男１０例，平均年龄５０岁。２９例患者中，接受了根治性手术（Ｍｉｌｅｓ手术）２３例。术后复发１７例，复发率为７４％（１７／２３），主要复发部位为远处转移。以性别，癌灶体积，色素产生，浸润深度和淋巴结转移为变量分析与预后的关系，仅淋巴结转移与术后复发的关系非常密切（Ｐ＜００５）。其余６例接受姑息性手术治疗。全组病例术后总５年生存率为２９％。根治性手术病例术后５年生存和无病生存率分别为３７％和２８％。未切除的６例全部死亡。中位生存期为１３５个月。结论肛管恶性直肠黑色素瘤是一种恶性程度极高的肿瘤。即使施行根治性外科手术治疗预后亦不佳。术中见到有淋巴结转移者预后更差。
Objective This study was designed to investigate the biological characteristics of anorectal
melanoma and the significance of radical operation for its treatment. MethodBZA retrospective
analysis was made of the clinical and pathological features as well as the results of surgical
treatment of 29 cases with anorectal melanoma collected from 1965 to 1995 in Cancer Hospital
of Chinese Academy of Medical Sciences. Results There were 19 females and 10 males with
their mean age of 50 years.Twentythree out of the 29 cases underwent curative resection
(Miles' operation), recurrences developed in 17 (74%) cases with major recurrence pattern of
distant metastasis. Only lymph node metastasis influenced the relapse of these patients when
analyzing variables such as gender, tumor size, melanin, invasive depth and lymph node
spread in terms of prognosis. The remaining six patients were submitted to palliative
surgery.The overall postoperative five year's survival rate of all patients and of that received
curative resection were 29% and 37% respectively. Six unresectable patients died of their
disease at a median of 135 months. HZ Conclusion anorectal melanoma is an aggressive
malignant tumor with poor prognosis even though radical resection was done. It was even
worse when lymph nodes were involved at the time of operation.
出处
《中华普通外科杂志》
CSCD
1999年第4期248-250,共3页
Chinese Journal of General Surgery
