Slisow W, Möhner M
Central Institute for Problems of Cancer, Berlin-Buch.
Vopr Onkol. 1991;37(1):76-80.
Eight hundred and eighty-six cases of rectal cancer diagnosed and reported to the National Cancer Registry in 1980 were submitted to obduction. Metastases were identified in 46.8%. Liver, lung and bones were affected in 38.7%, 16.1 and 3.5% of cases, respectively. Pattern of metastatic spread was determined by histology, with adenocarcinoma giving rise to blood-borne metastases, mucinous adenocarcinoma producing mostly lymphogenic metastases and signet-ring cell carcinoma spreading in either way. Isolated liver involvement was established in 9% of patients showing liver metastases at radical surgery. The parameter reached 22% when cases of presacral recurrence were excluded. A histologically oriented scheme is suggested to assure complete diagnostic coverage of metastases and to develop a concept for the treatment of liver secondaries. Targeted intraperitoneal and endolymphatic application of cytotoxic agents for the treatment of liver metastases aimed at reduction of extrahepatic dissemination is discussed.
1980年向国家癌症登记处诊断并报告的886例直肠癌病例接受了尸检。发现转移的病例占46.8%。肝脏、肺和骨转移分别见于38.7%、16.1%和3.5%的病例。转移扩散模式由组织学决定，腺癌产生血行转移，黏液腺癌主要产生淋巴转移，印戒细胞癌则以任何一种方式扩散。在根治性手术时发现有肝转移的患者中，9%为孤立性肝转移。排除骶前复发的病例后，这一参数达到22%。建议采用以组织学为导向的方案，以确保对转移灶进行全面诊断，并形成肝转移瘤的治疗概念。讨论了靶向腹腔内和淋巴管内应用细胞毒药物治疗肝转移瘤，旨在减少肝外播散。
