Järvinen H J, Ovaska J, Mecklin J P
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Br J Surg. 1988 Jan;75(1):25-7. doi: 10.1002/bjs.1800750110.
In a survey of the surgical results in 709 patients with colorectal carcinoma (CRC) treated between 1976 and 1985 a favourable shift of stage distribution was observed. The tumour was localized (Dukes' classification A or B) in 61 per cent of patients, as compared with 47 per cent in the previous 10-year period. This change was, in part, due to different interpretation of stage definitions. Clear improvements of the results were, however, also noted. Radical surgery was possible in 76 per cent of patients and the primary tumour was removed in 93 per cent. Surgical mortality was 4.4 per cent and complication rate 15 per cent, significantly less than earlier (6.5 and 38 per cent, respectively). Increasing numbers of sphincter-saving operations were performed in rectal cancers (47 per cent as compared with 24 per cent in the previous 10-year period). The overall 5-year survival rate improved from 40.5 to 52.5 per cent. Premalignant conditions were identified in 12.6 per cent of patients: previous CRC 4.8 per cent, cancer family syndrome 4.1 per cent, ulcerative colitis 1.7 per cent and familial adenomatosis 0.6 per cent. In order to sustain the favourable trend of improving survival prospects, more emphasis must be directed to the detection of early stage cancers.
在一项针对1976年至1985年间接受治疗的709例结直肠癌（CRC）患者手术结果的调查中，观察到分期分布出现了有利的变化。61%的患者肿瘤处于局部阶段（杜克分期A或B），而在前一个十年期这一比例为47%。这种变化部分归因于对分期定义的不同解读。然而，结果也有明显改善。76%的患者可行根治性手术，93%的患者切除了原发肿瘤。手术死亡率为4.4%，并发症发生率为15%，显著低于早期（分别为6.5%和38%）。直肠癌中保留括约肌手术的例数不断增加（47%，而在前一个十年期为24%）。总体5年生存率从40.5%提高到了52.5%。12.6%的患者被发现存在癌前病变：既往结直肠癌4.8%，癌症家族综合征4.1%，溃疡性结肠炎1.7%，家族性腺瘤病0.6%。为了维持生存前景改善的有利趋势，必须更加重视早期癌症的检测。
