Metzger U, Bronz K, Bühler H, Dolder A, Seefeld U, Hollinger A, Largiadèr F
Schweiz Med Wochenschr. 1985 Jul 20;115(29):1001-4.
207 patients curatively resected for colorectal cancer have been followed up in a prospective, controlled study using serial CEA, ultrasound, colonoscopy and clinical examination for early detection of recurrent tumor. After a median follow-up of 2.5 years, 52 recurrences (25%) have been detected, rising CEA value being the most sensitive indicator (86%) among the diagnostic procedures. 26 patients were reoperated for recurrent disease; in 10 out of 19 patients with local and 3 out of 7 patients with distant recurrence a potentially curative resection was possible. Median survival of patients not operated upon (n = 26) or incompletely resected (n = 13) is 8.5 months, whereas median survival for the 13 patients reoperated for cure has not yet been reached at 2 1/2 years. With respect to resectability, thorough clinical examination and endoscopy have been the most sensitive examinations (both 44%). Aggressive follow-up for suitable patients with colorectal cancer will detect most of the recurrences in an early asymptomatic phase, increase the rate of resectability and prolong survival in selected, curatively reresected cases.
对207例接受结直肠癌根治性切除的患者进行了一项前瞻性对照研究，采用连续癌胚抗原（CEA）检测、超声检查、结肠镜检查及临床检查，以早期发现复发性肿瘤。中位随访2.5年后，共检测到52例复发（25%），在诊断方法中，CEA值升高是最敏感的指标（86%）。26例患者因复发性疾病接受了再次手术；在19例局部复发患者中的10例以及7例远处复发患者中的3例中，有可能进行根治性切除。未接受手术（n = 26）或切除不完全（n = 13）的患者中位生存期为8.5个月，而13例接受根治性再次手术的患者在2.5年时仍未达到中位生存期。关于可切除性，全面的临床检查和内镜检查是最敏感的检查（均为44%）。对合适的结直肠癌患者进行积极的随访，将在早期无症状阶段发现大多数复发情况，提高可切除率，并延长部分接受根治性再次切除病例的生存期。
