Herzog U, Schuppisser J P, Tondelli P
Chirurgische Abteilung, St. Claraspital, Basel.
Schweiz Med Wochenschr. 1990 Apr 7;120(14):499-501.
144 patients with adenocarcinoma of the rectum underwent curative resection. In our retrospective study we were concerned with the influence of the tumor stage or the type of the resection on 5-year survival rates. The patients were 66 years old on average (range 37-88 years); 52% were women. Tumor distribution: 30% lower, 37% middle, 33% upper rectum. Tumor stage: 11% Nx, 26% Dukes A, 29% Dukes B, and 34% Dukes C tumors. Operation: 11% local excisions (transanal, trans-sphincteric), 71% anterior resections, 18% amputations. Absolute 5-year survival rate: Dukes A 78%, Dukes B 62%, Dukes C 33%, Nx tumors 75%. 5-year survival rate after local excisions (n = 16) 75%, after anterior resection (n = 102) 58%, and after rectum amputation (n = 26) 46%. 5-year survival rates in tumors of the lower rectum were similar to the whole group. The 5-year survival rate in cancer of the lower rectum after local excision is 92%, after anterior resection 67% and after rectum amputation 50%. The rate of pelvic recurrences after each type of resection is comparable (22-31%). Since the results after anterior resection are advantageous, this approach should be used more in tumors of the lower rectum.
144例直肠腺癌患者接受了根治性切除术。在我们的回顾性研究中，我们关注肿瘤分期或切除类型对5年生存率的影响。患者平均年龄66岁（范围37 - 88岁）；52%为女性。肿瘤分布：30%位于直肠下段，37%位于中段，33%位于上段。肿瘤分期：11%为Nx，26%为Dukes A期，29%为Dukes B期，34%为Dukes C期肿瘤。手术方式：11%为局部切除（经肛门、经括约肌），71%为前切除术，18%为直肠切除术。绝对5年生存率：Dukes A期为78%，Dukes B期为62%，Dukes C期为33%，Nx期肿瘤为75%。局部切除术后（n = 16）5年生存率为75%，前切除术后（n = 102）为58%，直肠切除术后（n = 26）为46%。直肠下段肿瘤的5年生存率与整个组相似。直肠下段癌局部切除术后5年生存率为92%，前切除术后为67%，直肠切除术后为50%。每种切除类型后的盆腔复发率相当（22% - 31%）。由于前切除术后的结果更有利，这种方法应更多地用于直肠下段肿瘤。
