Minsky B D, Mies C, Recht A, Rich T A, Chaffey J T
Department of Radiation Therapy, Harvard Medical School, Cambridge, Massachusetts.
Cancer. 1988 Apr 1;61(7):1408-16. doi: 10.1002/1097-0142(19880401)61:7<1408::aid-cncr2820610722>3.0.co;2-a.
In an effort to determine the patterns of failure and survival of rectosigmoid and rectal cancer, a retrospective review of 168 patients who underwent potentially curative surgery at the New England Deaconess Hospital was performed. The 5-year actuarial survival for the entire group was 67%. Survival rates decreased with increasing penetration of the bowel wall by tumor and the presence of lymph node metastasis, but only the latter reached statistical significance. Those patients who underwent an abdominoperineal resection also experienced a significant decrease in survival compared to a low anterior resection. Patterns of failure, expressed as the actuarial incidence of first failure at 5 years, were examined by stage. With the exception of stages B3 and C3, there was a trend towards increased abdominal, distant, and total failure with increasing bowel wall penetration by tumor. A similar trend was seen in local failure in those patients with positive nodes. Knowledge of these data may help identify those patients who may benefit most from adjuvant therapy.
为了确定直肠乙状结肠和直肠癌的失败与生存模式，我们对在新英格兰女执事医院接受了潜在根治性手术的168例患者进行了回顾性研究。整个组的5年精算生存率为67%。生存率随着肿瘤对肠壁浸润程度的增加以及淋巴结转移的出现而降低，但只有后者具有统计学意义。与低位前切除术相比，接受腹会阴联合切除术的患者生存率也显著降低。以5年首次失败的精算发生率表示的失败模式按分期进行了检查。除了B3期和C3期外，随着肿瘤对肠壁浸润程度的增加，腹部、远处和总体失败均有增加的趋势。在有阳性淋巴结的患者中，局部失败也有类似趋势。了解这些数据可能有助于确定哪些患者可能从辅助治疗中获益最大。
