Ohman U
Acta Chir Scand. 1985;151(8):675-9.
A 35-year (1950-1984) experience of colorectal carcinoma is surveyed. Intendedly curative resection was performed in 941 (70%) of the 1345 patients, this proportion being constant throughout the study. The operative mortality was 4.6%, falling from 12% in the early 1950s to less than 1%. Five-year survival, calculated for 1066 patients seen in 1950-1979, was 35% overall and 49% after surgery with curative intent. Improved survival rates were mainly due to decline in operative mortality. In Dukes' stages A, B and C the respective 5-year rates were 83, 48 and 22%. Retention of the original Dukes' system is advocated. Further improvement in results probably cannot be achieved via surgical management. Intensive follow-up routines have not revealed significant numbers of curable recurrences, and adjuvant treatment has been disappointing. To improve the long-term prospects, earlier diagnosis seems to be essential. Screening for fecal occult blood may be valuable, but proof awaits the results of randomized clinical trials.
对35年（1950 - 1984年）间的结直肠癌治疗经验进行了调查。1345例患者中有941例（70%）接受了根治性切除，这一比例在整个研究期间保持稳定。手术死亡率为4.6%，从20世纪50年代初的12%降至不到1%。对1950 - 1979年间就诊的1066例患者计算的5年生存率，总体为35%，根治性手术后为49%。生存率的提高主要归因于手术死亡率的下降。在Dukes分期A、B和C期，5年生存率分别为83%、48%和22%。主张保留原有的Dukes分期系统。通过手术治疗可能无法进一步提高疗效。强化随访程序未发现大量可治愈的复发病例，辅助治疗效果也不尽人意。为改善长期预后，早期诊断似乎至关重要。粪便潜血筛查可能有价值，但尚需随机临床试验的结果加以证实。
