ABSTRACT
Objective The objective of this was to investipate study the prognostic and influence factors in patients with transanal local resection for stage T1rectal cancer with the distance from anal margin≤8 cm. Methods A fotal of patients with 180 rectal cancer of stage T1with the distance from anal margin≤8 cm from March 2010 to March 2014 were Retrospective analysed,and there were 90 cases received the local resection of rectal cancer as the observation group and 90 patients with the T1stage who under-went radical resection of rectal cancer as the control group. The postoperative recovery effects were compared between the abservation and control groups. The rates of 3-year overall survival and progression-free survival were recorded. The prognostic influence factors of rectal cancer patients at the stage T1with the distance from the anal margin ≤8 cm after transanal local resection were analyzed. Results The operation time,intraoperative blood loss,postoperative anal exhaust time,postoperative hospitalization stay and postoper-ative complications were significantly lower in the observation group than those in the control group(P<0. 05). There were no signifi-cant difference in overall survival and progression free survival between the two groups(χ2= 0. 896,0. 358;P=0. 344,0. 550). Logis-tic multivariate analysis showed that age,degree of differentiation and cutting edge properties were independent risk factors for the prognosis of patients with rectal cancer who were≤8 cm from the anal margin(P<0. 05). Conclusion Transanal local resection for patients with rectal cancer T1stage from distance to anal margin can achieve similar prognostic benefits as radical surgery,and it can promote early recovery after surgery. Age,tumor differentiation and marginal properties are independent factors,which affected the prognosis of the patients undergoing surgery.
ABSTRACT
La calidad de vida de los pacientes debe tenerse en cuenta. Esta representa el resultado final de la actuación médica desde la perspectiva del paciente. En ocasiones solo nos basamos en este criterio para tomar decisiones terapéuticas ante determinadas enfermedades, como el carcinoma epidermoide de margen anal en estadío terminal. El tratamiento y conducta con fines paliativos tiene como objetivo mejorar la calidad de vida de estas personas. Presentamos el caso de paciente varón de 48 años de edad que acude a consulta por presentar lesión en el ano que no le permitía sentarse y después de realizársele todo el estudio necesario para determinar su diagnóstico definitivo (carcinoma epidermoide de ano) evaluarlo y determinar el tratamiento requerido para el grado de la enfermedad, nos percatamos que el tratamiento radical no cambiaba la evolución de su estado y se decide tratamiento paliativo para mejorar la calidad de vida. En ocasiones acuden a consulta pacientes que al culminar su estudio, obtienen el diagnóstico de una enfermedad avanzada y es, a partir de este momento, que nuestro pensamiento médico debe cambiar y encaminar nuestros esfuerzos a mejorar la calidad de vida y no llevarlos a un final tormentoso con el objetivo de revertir la evolución de una enfermedad que no tiene regresión(AU)
The quality of life of patients should be always borne in mind since it represents the final outcome of medical performance from the viewpoint of the patient. Occasionally, this is the only element that we have at our disposal to make therapeutic decisions in order to manage certain diseases such as terminal epidermoid carcinoma of the anal margin. The treatment and the behavior for palliative care are aimed at improving the quality of life of these patients. This is the case of 48 years-old male who went to the doctor´s because he presented with anal injure that prevents him from seating. After making all the necessary tests to arrive to a final diagnosis (epidermoid carcinoma of the anus), to assess him and to indicate the required treatment according to the extent of disease, we realized that the radical treatment would not change his condition and then we decided to apply palliative treatment to improve his quality of life. Some patients come to this service, and after being fully examined, they are diagnosed with advanced disease. From this moment on, our medical thinking should change to direct our efforts to the improvement of their quality of life rather than to guide them to a stormy end to reverse the progression of a disease that has no regression(AU)