演題抄録

臓器別シンポジウム

開催概要
開催回
第55回・2017年・横浜
 

結腸癌手術の現状と展望

演題番号 : OSY1-3

[筆頭演者]
猪股 雅史:1 
[共同演者]
河野 洋平:2、鈴木 浩輔:1、赤木 智徳:1、柴田 智隆:2、上田 貴威:3、當寺ヶ盛 学:1、白下 英史:1、衛藤 剛:1

1:大分大学・医学部・消化器・小児外科学講座、2:大分大学・医学部附属病院・高度救命救急センター、3:大分大学・医学部附属地域医療学センター

 

I. A standard surgical procedure for colon cancer
The concept of optimal surgery for colorectal cancer includes D3 resection, which preserves the mesocolic plane by sharp dissection off the parietal plane, taking any embryologic adhesions down and turning therefore embryologic development back, and dissects the regional lymph nodes with central tie of the supplying arteries at its origin. D3 resection has been widespread at the frequency of over 80% for stage II/III colon cancer, since " JSCCR Guideline for the treatment of colorectal cancer" was established in 2005. However, there is no prospective study evaluating its long-term outcome for D3 resection for colon cancer.

II. Long-term outcome of colectomy with D3 lymph node dissection
A RCT (JCOG0404) to evaluate open(OP) and laparoscopic(LAP) D3 resection for 1057 patients with stage II/III colon cancer was conducted in Japan. The rate of D3 resection was 99% in both OP and LAP groups(Jpn J Clin Oncol 2015). 5-year OS was 90.4% in OP, and 91.8% in LAP, and 5-year RFS was 79.7% in OP and 79.3% in LAP. The non-inferiority of LAP in OS was not demonstrated, however, OS was almost identical and better than expected in both groups, LAP is considered to be acceptable as a treatment option for stage II/III colon cancer(Lancet Gastroenterol & Hepatol 2017).

III. Future perspective of surgery for colon cancer
D3 resection will become more widespread as a standard surgical treatment for colon cancer, with the spread of laparoscopic surgery and comprehensive treatments, including pre/postoperative chemotherapy, which leads to the better prognosis and quality of life for patients.

前へ戻る