Enker W E, Laffer U T, Block G E
Ann Surg. 1979 Sep;190(3):350-60. doi: 10.1097/00000658-197909000-00010.
From 1966 through 1970 we performed resections in 216 patients with carcinoma of the large bowel. The relative five year survival for all patients was 65.5%. The relative five year survival for all potentially curable patients was 80.4%. Patients with positive lymph nodes and full-thickness penetration of their tumors had a five year survival of 70.5% and a 10 year survival of 60.5%. In performing this study we have tested the principles of wide anatomical resection and radical lymphadenectomy. For their specific influences on survival we have also examined stage, site, age, sex, race, margins, local recurrence, hypogastric lymph node dissection, serosal penetration and various aspects of nodal status. The information derived from these parameters has confirmed our hypothesis that survival is directly related to radical anatomical resection and lymphadenectomy. For rectal cancer, extensive resection also reduces the incidence of local recurrence. We are persuaded that the principles of operation for large-bowel cancer are valid and that they merit universal adoption.
1966年至1970年期间，我们对216例大肠癌患者进行了手术切除。所有患者的相对五年生存率为65.5%。所有潜在可治愈患者的相对五年生存率为80.4%。淋巴结阳性且肿瘤全层穿透的患者五年生存率为70.5%，十年生存率为60.5%。在进行这项研究时，我们检验了广泛解剖切除和根治性淋巴结清扫的原则。对于它们对生存的具体影响，我们还研究了分期、部位、年龄、性别、种族、切缘、局部复发、腹主动脉旁淋巴结清扫、浆膜穿透以及淋巴结状态的各个方面。从这些参数中获得的信息证实了我们的假设，即生存与根治性解剖切除和淋巴结清扫直接相关。对于直肠癌，广泛切除还可降低局部复发的发生率。我们深信，大肠癌的手术原则是有效的，值得广泛采用。
