Altendorf-Hofmann A, Scheele J
Chirurgische Klinik mit Poliklinik, Universität Erlangen-Nürnberg.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:231-8.
Tumor recurrence following "curative" resection (= R0) of gastrointestinal cancer occurs in 30% (colorectal carcinoma) to 70% (ductal pancreatic cancer) of patients. Only colorectal cancer recurrence involves a substantial chance of a reintervention which again may result in complete cancer clearance (local recurrence 17%, metachronous liver metastases 20%, other abdominal intracavitary relapse 12%, pulmonary secondaries 17%). Five-year survival after complete re-resection approaches 40% irrespectively of the site of recurrent disease. Recognition of resectable recurrence in asymptomatic patients is based on ultrasound, endoscopy, and chest X-ray. Laboratory investigations alone, and even CEA-screening, do not suffice.
胃肠道癌“根治性”切除（即R0）后，30%（结直肠癌）至70%（胰腺导管癌）的患者会出现肿瘤复发。只有结直肠癌复发有较大机会再次干预，而再次干预可能再次实现癌症的完全清除（局部复发17%，异时性肝转移20%，其他腹腔内复发12%，肺转移17%）。无论复发疾病的部位如何，完全再次切除后的五年生存率接近40%。对无症状患者可切除性复发的识别基于超声、内镜检查和胸部X光检查。仅靠实验室检查，甚至CEA筛查都不够。
