Seifart W, Marx G
Zentralbl Chir. 1985;110(2-3):120-3.
By long-time follow-up studies the authors maintain that the prognosis of colonic cancer is determined by distant metastases whereas the prognosis of rectal cancer after surgery for cure is essentially dependent on local recurrences. From that the consideration is derived to improve the prognosis of colonic cancer by an adjuvant chemotherapy, and of rectal cancer by increasing locoregional radicality which can only be attained by preoperative and/or postoperative irradiation. The individual risk of recurrence should be the indicator for an adjuvant therapy in addition to surgery. Some histological signs (grading of the tumour, cellular stromal reaction on the tumour site) correlate with prognosis and risk of recurrence. In this way it seems to be possible to define the high risk cases which may be improved by an adjuvant therapy.
通过长期随访研究，作者认为结肠癌的预后取决于远处转移，而直肠癌根治性手术后的预后主要取决于局部复发。由此得出这样的考虑，即通过辅助化疗改善结肠癌的预后，通过增加局部根治性来改善直肠癌的预后，而这只能通过术前和/或术后放疗来实现。除手术外，个体复发风险应作为辅助治疗的指标。一些组织学特征（肿瘤分级、肿瘤部位的细胞间质反应）与预后和复发风险相关。通过这种方式，似乎有可能界定出可通过辅助治疗改善预后的高风险病例。
