直肠癌肿瘤分期与手术方式ppt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, Veldkamp R, et al

2、. 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 13Open colectomyLaparoscopic colectomyDifferenceDisease-free survival3 years76.2(72.6-79.8)74.2(70.4-78.0)2.0(-3.2 to 7.2)5

3、years67.9(63.6-72.2)66.5(62.2-70.7)1.4(-4.6 to 7.5)Overall Survival3 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Buunen M, Veldkamp R, et a

4、l. 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 13Cancer recurrence or death from any cause (DFS)Overall mortality (OS)HR (95% CI)P valueHR (95% CI)P valueProcedureOpen vs

5、 Laparoscopic colectomy0.93(0.74-1.15)0.490.95(0.74-1.22)0.70Stage 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)0.001SexWomen vs men0.81(0.65-1.01)0.060.67(0.52-0.86)0.002AgePer 10-year increase1.42(1.27-1.59)0.0011.80(1.57-2.06)0.001Reference 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