Adloff M, Arnaud J P, Bergamaschi R, Schloegel M
Department of Surgery, Centre Medico-Chirurgical et Obstetrical de la Securite Sociale, Schiltigheim, France.
Am J Surg. 1989 Mar;157(3):299-302. doi: 10.1016/0002-9610(89)90555-2.
In a series of 1,037 patients with colorectal carcinoma diagnosed at one hospital during a 9-year period, synchronous cancers of the colon and rectum occurred in 2 percent. Patient characteristics and presenting symptoms were similar in single and synchronous carcinomas. The frequency of patients with associated benign neoplasms was significantly higher than that in the parent series. An examination of the modified Dukes' classification stage of the lesion in each patient revealed a higher incidence of lymph node involvement and a greater frequency of mucinous adenocarcinoma in patients with synchronous carcinomas. The 5-year survival of patients with synchronous growths did not differ from that of patients with single lesions, even when classified by Dukes' stage. Preoperative diagnosis was difficult, being achieved in no more than 30 percent of patients. Because of the poor accuracy of barium studies, total colonoscopy is the method of choice for this evaluation. We adopted a conservative surgical policy backed by life-long follow-up.
在一家医院9年期间诊断出的1037例结肠直肠癌患者中，2%发生了结肠和直肠同时性癌。单发癌和同时性癌患者的特征及出现的症状相似。伴有良性肿瘤患者的比例显著高于总体病例系列。对每位患者病变的改良Dukes分期检查显示，同时性癌患者的淋巴结受累发生率更高，黏液腺癌的比例更高。即使按Dukes分期分类，同时性生长患者的5年生存率与单发病变患者并无差异。术前诊断困难，不超过30%的患者能够实现。由于钡剂造影检查准确性差，全结肠镜检查是此项评估的首选方法。我们采取了保守的手术策略，并进行终身随访。
