直肠癌肿瘤分期与手术方式医学课件

1、 Haggitts分类法分类法 SM分级分级 Lacy AM, GarciaVa ldecasas JC, De lgado S, et a.l Laparoscopic assisted colectomy vs open colectomy for treatment of nonmetastatic colon cancer: a random ized trial J. Lancet, 2002, 359( 9325): 2224- 2249 远期疗效，5年生 存率及无复发生存 率与开腹手术相同 近期效果，腹腔 镜手术和开腹手 术无差别 COLOR研究 Buunen M, Veldka

2、mp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009 Jan;10(1):44-52. Epub 2008 Dec 13 Open colectomyLaparoscopic colectomy Difference Disease-free survival 3 years76.2(72.6-79.8)74.2(70.4-78.0)2.0

3、(-3.2 to 7.2) 5 years67.9(63.6-72.2)66.5(62.2-70.7)1.4(-4.6 to 7.5) Overall Survival 3 years84.2(81.1-87.3)81.8(78.4-85.1)2.4(-2.1 to 7.0) 5 years74.2(70.1-78.2)73.8(69.7-77.9)0.4(-5.3 to 6.1) Data given are percentages (95% CI ) Table 4: Survival at 3 and 5 years according to procedure. COLOR研究 Buu

4、nen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009 Jan;10(1):44-52. Epub 2008 Dec 13 Cancer recurrence or death from any cause (DFS) Overall mortality (OS) HR (95% CI)P valueHR (95%

5、CI)P value Procedure Open vs Laparoscopic colectomy 0.93(0.74-1.15)0.490.95(0.74-1.22)0.70 Stage vs 1.29(.093-1.79)0.131.13(0.77-1.65)0.53 vs 2.64(1.92-3.63)0.0012.60(1.82-3.71)0.001 Sex Women vs men0.81(0.65-1.01)0.060.67(0.52-0.86)0.002 Age Per 10-year increase1.42(1.27-1.59)0.0011.80(1.57-2.06)0.001 Reference categories for the categorical variables are laparoscopy procedures, stage disease, and male sex. Table 5: Multivariable analysis (Cox-regression) of disease-free survival (DFS) and overall survival (OS) according to various factors. 机器人 机器人 借助机械臂和 3D显像系统