頁籤選單縮合
題 名 | Perianal Paget's Disease, Report of 20 Cases=肛門Paget's氏症,20例病例 |
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作 者 | 邵彥誠; 林宏鑫; 林春吉; 藍苑慈; 張世慶; 王煥昇; 林資琛; 陳維熊; 林楨國; 姜正愷; 楊純豪; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷 期 | 27:1 2016.03[民105.03] |
頁 次 | 頁51-56 |
分類號 | 416.245 |
關鍵詞 | 肛門直腸癌; 肛門Paget's; 局部廣泛性切除; 腹部會陰部切除; Anorectal carcinoma; Perianal Paget's disease; Wide local excision; Abdominoperineal resection; |
語 文 | 英文(English) |
中文摘要 | 背景:肛門Paget’s氏症是一罕見疾病。臨床上常見合併肛門直腸癌。本研究目的為回顧本院在此疾病的診斷、處置以及成效。方法:從臺北榮民總醫院大腸直腸外科以及病理科資料庫中擷取了2000年至2014年於本院接受治療的肛門Paget’s氏症患者。統計分析臨床表徵及病理等因子與復發及存活率之間的關係。結果:共有20名(12名男性)患者收錄至本研究中,平均年齡76歲;13名個案合併有肛門直腸癌,7名則無。最常見的症狀為流血及肛門疼痛。合併有肛門直腸癌的患者五年存活率為66.1%。9名接受根除性手術的患者中,有8名在追蹤過程中無疾病復發。結論:高比例的患者合併有肛門直腸癌。接受局部廣泛性切除的單純肛門Paget’s氏症患者,有相對較高的復發率。追蹤過程中需注意復發疾病惡性化。若無惡性化,多次局部廣泛性切除是可行的。對於合併有肛門直腸癌的患者,廣泛性手術有可接受的局部及遠端腫瘤控制。 |
英文摘要 | Backgraound. Perianal Paget’s disease (PPD) is a rare disease and usually delayed in diagnosis. Association with anorectal carcinoma is often observed. The purpose of this study was to review the diagnosis, management, and outcomes of patients with perianal Paget’s disease at our hospital. Method. Database of Pathology and Colorectal surgery at Taipei Veterans General Hospital were queried for all cases of perianal Paget’s disease at Taipei Veterans General Hospital between 2000 and 2014. Clinical pathologic factors were investigated for association with recurrence and survival. Twenty patients with perianal Paget’s disease were included in the study (12male),median age at diagnosis, 76 years [range, 52-88 years]; and 13 with synchronous internal malignancy, 7 without. Results. The most common symptoms were perianal bleeding and painful sensation. The 5-year overall survival of perianal Paget’s disease with synchronous internal malignancy was 66.1 %. In nine patients with curative surgery, eight were disease-free during follow-up. Conclusion. High incidence of concomitant internal malignance is noted. A relative high local recurrent rate for pure perianal Paget’s disease receiving wide excision is present. Malignant transformation should be alerted at finding recurrence. If not malignance, repeated wide excision for local recurrence may be feasible. Radical surgery for perianal Paget’s disease with internal malignancy (PPDIM) had acceptable oncological control, for local and distant. |
本系統中英文摘要資訊取自各篇刊載內容。