Quentmeier A, Schlag P, Smok M, Herfarth C
Department of Surgery, University of Heidelberg FRG.
Eur J Surg Oncol. 1990 Aug;16(4):319-25.
Between 1978 and 1986, 179 patients with recurrent colorectal cancer were treated and 137 patients were operated a second time.82.1% of the patients showed elevated CEA levels (greater than or equal to 5 ng/ml) at the time of diagnosis. In 58.1% of the patients the CEA increase preceded the recognition of recurrence, and in 13.4% the diagnosis could be confirmed only by a second-look operation. In 46.7% of the re-operated patients a potentially curative resection of the locally recurrent or metastatic disease could be performed. The resectability was significantly lower in patients with symptomatic recurrent disease (34.5%) as compared to asymptomatic patients with CEA-directed positive imaging (52.7%) and the second-look patients (62.5%) respectively. A significant improvement in survival could be achieved especially in the second-look operated patients.
1978年至1986年间，179例复发性结直肠癌患者接受了治疗，137例患者接受了二次手术。82.1%的患者在诊断时癌胚抗原（CEA）水平升高（大于或等于5 ng/ml）。在58.1%的患者中，CEA升高先于复发的确认，在13.4%的患者中，仅通过二次探查手术才能确诊。在46.7%的再次手术患者中，可以对局部复发或转移性疾病进行潜在的根治性切除。有症状的复发患者的可切除性（34.5%）明显低于CEA引导下影像学检查阳性的无症状患者（52.7%）和二次探查手术患者（62.5%）。尤其是二次探查手术患者的生存率有显著提高。
