Helfritzsch H, Böhm B, Thiele M, Altendorf-Hoffmann A, Scheele J
Klinik für Allgemeine und Viszerale Chirurgie, Universität Jena, Germany.
Zentralbl Chir. 2002 Apr;127(4):302-6. doi: 10.1055/s-2002-31558.
In every 7th patient with colorectal cancer tumor has already spread beyond intestinal wall into surrounding organs.
Between 01. 01. 1990 and 31. 12. 1998 763 patients with colorectal cancer were treated at our surgical department. 166 patients (23 %) presented with tumor contiguous or adherent to adjacent organs (cT4).
In most cases tumor was localized in colon (109 patients, 66 %), in 57 patients (34 %) tumor was found in rectum. Potenzial curative resection (R0) was possible in 67 patients (40 %). 66 patients (40 %) had microscopic (R1) or gro beta residual disease (R2) and in 33 patients only palliative surgery was possible. Extended resection of adjacent organs was performed in 97 % in the group with curative resection. 11 patients (8 %) died after multivisceral resection. The 5-year survival for curative resection was 57 %, for patients with microscopic or gro beta residual disease 9 months and for palliative surgery only 4 months.
Optimistic longterm results in advanced colorectal cancer can only be achieved after curative resection. After incomplete resection or palliative surgery median life expectancy is extremely poor.
每7名结直肠癌患者中就有1名肿瘤已扩散至肠壁以外并侵犯周围器官。
1990年1月1日至1998年12月31日期间，我院外科共治疗763例结直肠癌患者。166例（23%）患者的肿瘤与相邻器官相连或粘连（cT4）。
大多数情况下肿瘤位于结肠（109例，66%），57例（34%）肿瘤位于直肠。67例（40%）患者可行根治性切除（R0）。66例（40%）患者有镜下（R1）或大体残留病灶（R2），33例患者仅可行姑息性手术。根治性切除组97%的患者进行了相邻器官的扩大切除。11例（8%）患者在多脏器切除术后死亡。根治性切除患者的5年生存率为57%，有镜下或大体残留病灶的患者为9个月，仅行姑息性手术的患者为4个月。
晚期结直肠癌只有在根治性切除后才能取得乐观的长期疗效。不完全切除或姑息性手术后，中位预期寿命极差。
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