De Quay N, Cerottini J P, Albe X, Saraga E, Givel J C, Caplin S
Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Eur J Surg. 1999 Jun;165(6):588-92. doi: 10.1080/110241599750006514.
To assess whether Jass staging enhances prognostic prediction in Dukes' B colorectal carcinoma.
A historical cohort observational study.
A university tertiary care centre, Switzerland.
108 consecutive patients.
Curative resection of Dukes' B colorectal carcinoma between January 1985 and December 1988, Patients with familial adenomatous polyposis; hereditary non-polyposis colorectal cancer; Crohns' disease; ulcerative colitis and synchronous and recurrent tumours were excluded. A comparable group of 155 consecutive patients with Dukes' C carcinoma were included for reference purposes.
Disease free and overall survival for Dukes' B and overall survival for Dukes' C tumours.
Dukes' B tumours in Jass group III or with an infiltrated margin had a significantly worse disease-free survival (p = 0.001 and 0.0001, respectively) and those with infiltrated margins had a significantly worse overall survival (p = 0.002). Overall survival among those with Dukes' B Jass III and Dukes' B with infiltrated margins was no better than overall survival among all patients with Dukes' C tumours.
Jass staging and the nature of the margin of invasion allow patients undergoing curative surgery for Dukes' B colorectal carcinoma to be separated into prognostic groups. A group of patients with Dukes' B tumours whose prognosis is inseparable from those with Dukes' C tumours can be identified, the nature of the margin of invasion being used to classify a larger number of patients.
评估雅氏分期（Jass staging）能否增强对Dukes B期结直肠癌的预后预测。
一项历史性队列观察研究。
瑞士的一家大学三级护理中心。
108例连续患者。
1985年1月至1988年12月期间对Dukes B期结直肠癌进行根治性切除，排除患有家族性腺瘤性息肉病、遗传性非息肉病性结直肠癌、克罗恩病、溃疡性结肠炎以及同时性和复发性肿瘤的患者。纳入155例连续的Dukes C期癌患者作为对照。
Dukes B期患者的无病生存率和总生存率以及Dukes C期肿瘤患者的总生存率。
雅氏分期为III期或切缘浸润的Dukes B期肿瘤患者的无病生存率显著较差（分别为p = 0.001和0.0001），切缘浸润的患者总生存率显著较差（p = 0.002）。雅氏III期Dukes B期和切缘浸润的Dukes B期患者的总生存率并不优于所有Dukes C期肿瘤患者的总生存率。
雅氏分期和浸润边缘的性质可将接受Dukes B期结直肠癌根治性手术的患者分为不同预后组。可以识别出一组Dukes B期肿瘤患者，其预后与Dukes C期肿瘤患者无法区分，浸润边缘的性质可用于对更多患者进行分类。
