目的:女性患者局部晚期原发性直肠癌盆腔后肠管切除术的手术技术和预后构成了需要解决的挑战。因此,我们采用一种新的北京分类方法,调查了女性患者盆腔后肠切除术的短期结局和生存结局.
方法:我们回顾性分析了来自中国PelvEx合作的三个三级转诊中心的前瞻性数据库。共有172例接受局部晚期原发性直肠癌联合切除术的患者根据四种亚型进行分类(PPE-I[64/172],PPE-II[68/172],PPE-III[21/172],和PPE-IV[19/172]),根据北京分类;分析了围手术期特征以及短期和肿瘤结局。
结果:四组在结直肠重建方面存在显著差异(p<0.001),会阴重建术(p<0.001),住院并发症(p<0.05),尿潴留(p<0.05)。PPE-I的R0切除率,PPE-II,PPE-III,PPE-IV为90.6%,89.7%,90.5%,和89.5%,分别。PPE-I的5年总生存率,PPE-II,PPE-III,PPE-IV组为73.4%,68.8%,54.7%,和37.3%,分别。相应地,他们的5年无病生存率为76.0%,62.5%,57.7%,和43.1%,分别。值得注意的是,PPE-IV组的5年总生存率最低(p<0.001),5年无病生存率最低(p<0.001).
结论:北京分类有助于确定合适的手术技术,并对女性局部晚期原发性直肠癌患者进行预后评估。
OBJECTIVE: Surgical techniques and the prognosis of posterior pelvic exenteration for locally advanced primary rectal cancer in female patients pose challenges that need to be addressed. Therefore, we investigated the short-term and survival outcomes of posterior pelvic exenteration in female patients using a novel Peking classification.
METHODS: We retrospectively analysed a prospective database from China PelvEx Collaborative across three tertiary referral centres. A total of 172 patients who underwent combined resection for locally advanced primary rectal cancer were classified based on four subtypes (PPE-I [64/172], PPE-II [68/172], PPE-III [21/172], and PPE-IV [19/172]) according to the Peking classification; perioperative characteristics and short-term and oncological outcomes were analysed.
RESULTS: Differences were significant among the four groups regarding colorectal reconstruction (p < 0.001), perineal reconstruction (p < 0.001), in-hospital complications (p < 0.05), and urinary retention (p < 0.05). The R0 resection rates for PPE-I, PPE-II, PPE-III, and PPE-IV were 90.6%, 89.7%, 90.5%, and 89.5%, respectively. The 5-year overall survival rates of the PPE-I, PPE-II, PPE-III, and PPE-IV groups were 73.4%, 68.8%, 54.7%, and 37.3%, respectively. Correspondingly, their 5-year disease-free survival rates were 76.0%, 62.5%, 57.7%, and 43.1%, respectively. Notably, the PPE-IV group demonstrated the lowest 5-year overall survival rate (p < 0.001) and 5-year disease-free survival rate (p < 0.001).
CONCLUSIONS: The Peking classification can aid in determining suitable surgical techniques and conducting prognostic assessments in female patients with locally advanced primary rectal cancer.