Stolte M, Lauer E
Institut für Pathologie, Klinikum Bayreuth.
Leber Magen Darm. 1992 Jul;22(4):145-9.
With the aim of investigated the question as to whether surgery for colorectal carcinoma is being carried out in a standardised tumor-oriented manner, 777 surgical specimens containing colorectal carcinomas obtained from 33 hospitals were analysed. Only 4.76% of these carcinomas were pT 1 early carcinomas, the largest portion of the tumors (63.96%) was classified as pT 3. The pN stages were distributed as follows: pN 0 53.4%, pN 1 22.0%, pN 2 13.77%, pN 3 9.39%, and pN X 1.41%. The surgeons indicated an R-classification in only 24% of the specimens. Measurements of the length of the resected material, the width of the mesocoli or perirectal tissue, the distal margin of clearance, the number of lymph nodes on the vessel trunk, and the number of pericolic or perirectal lymph nodes revealed a considerable degree of fluctuation in the measurements, and thus in the operative methodology applied to colorectal carcinoma surgery. Analysis of the four hospitals with the highest operating rates taking sigmoidorectal specimens as an example, showed that some abdominal surgeons are still not performing this operation in accordance with the oncological rules for tumor-oriented surgery.