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| 題 名 | Treatment Response in Patients with Primary Colonic Lymphomas: Experience in a Single Institute=原發性結腸惡性淋巴癌單一醫學中心之治療經驗 |
|---|---|
| 作 者 | 吳岳嶸; 盧建璋; 林尚潁; 張家駱; 胡萬祥; 李克釗; 陳鴻華; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
| 卷 期 | 23:2 2012.06[民101.06] |
| 頁 次 | 頁39-47 |
| 分類號 | 416.245 |
| 關鍵詞 | 惡性淋巴癌; 輔助性化學治療; 結腸與直腸; B細胞; Lymphoma; Colorectal; Adjuvant chemotherapy; B-cell; |
| 語 文 | 英文(English) |
| 中文摘要 | 目的原發性結腸惡性淋巴癌為少見惡性腫瘤。本研究回顧高雄長庚紀念醫院過去治療 結腸惡性淋巴癌之經驗,並就臨床特徵及預後進行論述。 方法回顧收集於1989 至2009 年間本院結直腸癌登記資料庫中,診斷為結直腸癌之 8,953 名病患裡,病理診斷為惡性淋巴癌者共21 例。分析上述病患個別醫療紀錄,並就 其臨床表徵、病理分類、腫瘤位置、期別、治療成效、復發情形及存活率等進行分析。 結果統計發現病患以男性居多,男女比為16 比5,平均年齡為53.9 歲。臨床表徵為 腹痛或腹脹。腫瘤好發位置為盲腸居多,升結腸次之。只有兩位病人於治療前藉由大腸 鏡切片證實為惡性淋巴癌,其餘病人大多是由手術病理診斷確診。病理報告發現主要型 態為B 細胞淋巴癌,在此研究中並無發現T 細胞淋巴癌。有17 例病人接受手術,其中 10 例為根除性手術,7 例為緩和性手術。接受化學治療的病人有12 例。五年存活率為 42.9%。統計結果發現,診斷時的期別、接受根除性手術、非急診手術及化學藥物治療 和病人預後有顯著相關 (p < 0.05)。 結論原發性結腸直腸惡性淋巴癌的治療建議為多元整合治療模式,患者若可以接受根 除性手術,術後併之輔助性化學治療,對預後是有幫助的。 |
| 英文摘要 | Purpose. To review the clinical characteristics, treatments and prognosis of the rare malignancy, primary colonic lymphoma at a single-institute in southern Taiwan. Methods. More than 8953 colon or rectal cancers were reviewed at Chang Gung Medical Center in Kaohsiung from 1989 to 2009, with only 21 cases diagnosed as primary colonic lymphoma. The records of those patients were retrospectively analyzed for age, gender, clinical presentation, location and stage of tumor, operation, adjunctive therapy, survival time and clinical outcome. Cox regression and Kaplan-Meier methods were applied to estimate the prognostic factors for the patient survival time. Results. Twenty-one patients with primary colonic lymphoma were identified which constituted 0.2% of all reported cases of colorectal cancer in our institute. The mean age at diagnosis was 53.9 years (range, 15-86 years), with a male to female ratio of 16:5. The most common tumor site was the cecum, followed by the ascending colon. All patients had B-cell lymphoma. Seventeen patients had undergone an operation. The chemotherapy was applied to 12 patients out of 21. The overall five-year survival rate was 42.9% (N = 21, median survival time: 12.7 months). Prognostic factors including disease stage, operation method (curative vs. palliative), operation timing (elective vs. emergency) and chemotherapy showed a significant influence on the survival time (all p < 0.05). Conclusion. The choice of treatment for primary colorectal lymphoma is multimodality, adequate curative surgical resection in selected patients followed by adjuvant chemotherapy seems to result in a favorable outcome. |
本系統中英文摘要資訊取自各篇刊載內容。