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Multiple Primary Colorectal Cancer Diagnosis and Surgical Treatment

Author: GuLiang
Tutor: ZhaoYongFu
School: Dalian Medical University
Course: Surgery
Keywords: colonorectal carcinoma Multiple primary carcinoma diagnosis surgical treatmen t prognosis
CLC: R735.3
Type: Master's thesis
Year: 2011
Downloads: 8
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Objective:To investigate the clinic features and to improve the understanding of multiple primary colonorectal carcinomas (MPCC) by analysing the related factors of diagnosis, treatment and prognosis.Methods: The clinical data of 28 patients with MPCC from 2224 primary colonorectal carcinomas, admitted in the second affiliated hospital of Dalian Medical University, were reviewed. Clinical pathological parameters, such as the gender, age, family history, operation types, pathological types and clinical pathological stages were compared with 2224 patients with primary colonorectal carcinomas at the same period. Based on the data from 2006, the Cox regression model was used to analyze prognosis of the patients.Results: In the total 28 MPCC cases, 17 of them are male and 11 of them are female; the age range is from 29 to 71 with the average 52 ages; 24 cases (1.72%) are SC and 4 cases (0.57%) are MC. The overall number of focus is 60 and the common locations are sigmoid 15 cases (39%), rectum 16 cases (42%), and acending colon 7 cases (19%). In the 26 SC cases, 16 of them are found by fibrocolonoscopy, abdominal CT and abdominal Barium meal examination, and 10 of them are found in the operation. The following-up colonoscopy found 2 MC cases. All of the 28 patients are treated by surgery. Among them, 22 cases are operated by regularised curative operation, 5 cases are operated by palliative operation,1 case is operated by shortcut operation. All the 28 cases are followed up, and 16 of them survive in 5 years. However, only 1 survive in the 4 nonradical operations in five years. The COX regression model analysis shows that the operation types, TNM stages and integrated treatment are the main independent factors among all the related prognostic factors. Conclusion: Using the current techniques like fibrocolonoscopy, CT and X-ray scans can reduce the Misdiagnosis and Missed rate. Fibrocolonoscopy and X-ray before operation and careful examine in operation are important methods to discover SC. At the same time, follow-up after operation can not be neglected. However, the most important thing is to pay more attention, to try to diagnose as early as possible and to use radical operation with other accessory physical treatment.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms
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