Hillon P, Faivre J, Milan C, Bedenne L, Piard F, Klepping C
Gastroenterol Clin Biol. 1985 Oct;9(10):704-11.
The population based registry of digestive cancers in the french county of Côte-d'Or enables a study of the treatment and prognosis of colorectal cancers. During 1976-1981, 587 rectal cancers and 717 colon cancers were diagnosed. Curative resection was performed in 61 p. 100 of rectal and colon cancers. Operative mortality after curative resection was 9.7 p. 100 for rectal cancers and 13.1 p. 100 for colon cancers. The overall 5 year observed survival rate was 26.5 p. 100 for rectal cancers and 29.8 p. 100 for colon cancers. After curative surgery, 5 year corrected survival rates was 57.2 p. 100 for rectal cancers and 66.9 p. 100 for colon cancers. Five year survival rate was related to the topography of the cancer (it was lower for caecal cancers), to the macroscopic type of growth (it was higher for exophytic carcinomas than for infiltrative carcinomas) and to the size (it was higher for tumors less than 3 cm than for larger tumors). The major determinant of the survival was the pathological stage of the tumor. Patients with Dukes' A lesions at the time of curative surgery had almost the same life expectancy as persons without rectum or colon cancer. These data suggest that a substantial improvement in prognosis might result from earlier diagnosis of the disease. This commands modifications in the policy of detection of colorectal cancers.
法国科多尔省基于人群的消化系统癌症登记处有助于对结直肠癌的治疗和预后进行研究。在1976年至1981年期间，共诊断出587例直肠癌和717例结肠癌。直肠癌和结肠癌的根治性切除率为61%。根治性切除术后，直肠癌的手术死亡率为9.7%，结肠癌为13.1%。直肠癌的总体5年观察生存率为26.5%，结肠癌为29.8%。根治性手术后，直肠癌的5年校正生存率为57.2%，结肠癌为66.9%。5年生存率与癌症的部位（盲肠癌的生存率较低）、大体生长类型（外生性癌的生存率高于浸润性癌）和大小（肿瘤小于3 cm的生存率高于较大肿瘤）有关。生存的主要决定因素是肿瘤的病理分期。根治性手术时处于Dukes' A期病变的患者的预期寿命几乎与无直肠癌或结肠癌的人相同。这些数据表明，疾病的早期诊断可能会使预后得到实质性改善。这就要求对结直肠癌的检测策略进行调整。
