Hunter J A, Ryan J A, Schultz P
Am J Surg. 1987 Jul;154(1):67-71. doi: 10.1016/0002-9610(87)90292-3.
This study was undertaken to determine the optimal surgical treatment of colorectal cancers with adherence to adjacent organs in the absence of distant metastases. A retrospective review of colorectal cancer at Virginia Mason Hospital from 1975 to 1979 divided patients with Dukes' stage B2 and C2 colorectal cancers into three treatment groups: standard colectomy, en bloc resection, and colectomy with separation of adherent organs, with 5 year survival rates of 55 percent, 61 percent, and 23 percent, respectively. No operative mortality occurred with en bloc resection. Survival after en bloc resection was influenced by Dukes' stage and the histologic documentation of cancer within the adherent organ. Unacceptably high local recurrence rates and poor 5 year survival rates were observed in cases where adherent organs were separated from the colorectal cancer. We conclude that colorectal cancer adherent to other organs should be treated by en bloc resection. The survival rate after en bloc resection will be comparable to the rate after standard colectomy for nonadherent colorectal cancers.
本研究旨在确定在无远处转移情况下，对与相邻器官粘连的结直肠癌的最佳手术治疗方法。对弗吉尼亚梅森医院1975年至1979年的结直肠癌进行回顾性研究，将杜克B2期和C2期结直肠癌患者分为三个治疗组：标准结肠切除术、整块切除术以及粘连器官分离的结肠切除术，5年生存率分别为55%、61%和23%。整块切除术未发生手术死亡。整块切除术后的生存受杜克分期以及粘连器官内癌症的组织学记录影响。在粘连器官与结直肠癌分离的病例中，观察到局部复发率高得令人无法接受且5年生存率低。我们得出结论，与其他器官粘连的结直肠癌应采用整块切除术治疗。整块切除术后的生存率将与非粘连性结直肠癌标准结肠切除术后的生存率相当。
