Reifferscheid M, Fass J, Hartung R, Mittermayer C
Abteilung Chirurgie der RWTH Aachen.
Langenbecks Arch Chir. 1987;371(3):193-200. doi: 10.1007/BF01259430.
752 patients with colon carcinoma of the years 1966-1985 were studied retrospectively. 189 tumors were located in the right and 563 in the left colon. There was no difference in the 5-year survival rate, Dukes classification and operative mortality in both groups. Considering the higher median of tumor diameter, the three months longer diagnostic delay and the twice higher rate of undifferentiated carcinomas the prognosis of the right sided tumors is relatively better. In our opinion the cause of this more efficient local tumor defence is the better blood and lymph supply of the right colon and mucosal mechanisms. Expression of this better tumor defence is the distinct tumor colitis in the right colon. Improvement of the right colon carcinoma prognosis is to be expected of earlier tumor diagnosis. Routine endoscopic evaluation of hemoccult positive subjects is most helpful.
对1966年至1985年间的752例结肠癌患者进行了回顾性研究。189例肿瘤位于右半结肠，563例位于左半结肠。两组患者的5年生存率、Dukes分期和手术死亡率无差异。考虑到右侧肿瘤直径中位数较高、诊断延迟长三个月以及未分化癌发生率高出两倍，右侧肿瘤的预后相对较好。我们认为，这种更有效的局部肿瘤防御的原因是右半结肠更好的血液和淋巴供应以及黏膜机制。这种更好的肿瘤防御的表现是右半结肠明显的肿瘤性结肠炎。早期肿瘤诊断有望改善右半结肠癌的预后。对潜血阳性患者进行常规内镜评估非常有帮助。
