Chapuis P H, Fisher R, Dent O F, Newland R C, Pheils M T
Dis Colon Rectum. 1985 Mar;28(3):158-61. doi: 10.1007/BF02554232.
A routine clinicopathologic (CP) staging system for patients who have had surgical resection for colorectal carcinoma was established at Concord Hospital in 1971. Research on this prospective series of resections has evaluated the CP staging system as a guide to prognosis. The aim of this study was to compare the CP system with the classic Dukes' staging system and its modified form introduced by Astler and Coller to determine which method provided the most accurate basis for prognosis. Life table survival analysis was used to examine the survival of 709 patients according to each staging system. Relative mortality rates for groups of patients cross-classified by each possible pair of staging systems were examined and the Cox regression model was used to determine the independent effects of staging by each system on survival. The CP system was found to have a stronger association with survival than either the classic Dukes' system or the Astler-Coller modification of the Dukes' system. The importance of supplementing data on the operative specimen with data about the spread of tumor beyond the limits of surgical resection is emphasized.
1971年，康科德医院为接受过结直肠癌手术切除的患者建立了一套常规临床病理（CP）分期系统。对这一系列前瞻性切除病例的研究评估了CP分期系统作为预后指导的作用。本研究的目的是将CP系统与经典的杜克斯分期系统及其由阿斯特勒和科勒引入的改良形式进行比较，以确定哪种方法为预后提供了最准确的依据。采用生命表生存分析，根据每个分期系统检查了709例患者的生存情况。对按每种可能的分期系统配对交叉分类的患者组的相对死亡率进行了检查，并使用Cox回归模型确定每个系统分期对生存的独立影响。结果发现，CP系统与生存的关联比经典的杜克斯系统或杜克斯系统的阿斯特勒 - 科勒改良版更强。强调了用肿瘤超出手术切除范围的扩散数据补充手术标本数据的重要性。
