Bear H D, MacIntyre J, Burns H J, Jarrett F, Wilson R E
Am J Surg. 1984 Apr;147(4):441-6. doi: 10.1016/0002-9610(84)90002-3.
Multiple clinical and pathologic factors have been analyzed retrospectively for a group of 456 patients with colon and rectal cancer treated in Glasgow over a span of 4 years. Sixty-five percent of these patients underwent curative resection, and another 16 percent had palliative resection. Obstruction and perforation (present in 19 and 5 percent, respectively) were associated with the highest operative mortality (17 percent for both) of any presenting symptom. However, when only patients who survived curative resection were considered, obstruction carried only a slightly lower 5 year survival than did other common symptoms, whereas perforation still led to only a 10 percent 5 year survival. Neither mucin production nor degree of differentiation influenced survival significantly. Adherence of the primary tumor to an adjacent organ was associated with a very poor prognosis (9 percent 5 year survival), but curative resection of the involved organs with the primary tumor increased the 5 year survival to 34 percent. Patterns of recurrence were noted to be markedly different for each primary site and for different stages. Dukes' stage was the most important overall determinant of prognosis.
对格拉斯哥4年间收治的456例结肠癌和直肠癌患者的多项临床和病理因素进行了回顾性分析。这些患者中有65%接受了根治性切除，另有16%接受了姑息性切除。梗阻和穿孔（分别占19%和5%）与任何症状中最高的手术死亡率（均为17%）相关。然而，仅考虑根治性切除后存活的患者时，梗阻的5年生存率仅略低于其他常见症状，而穿孔导致的5年生存率仍仅为10%。黏液产生和分化程度均未对生存率产生显著影响。原发性肿瘤与相邻器官粘连与预后极差相关（5年生存率为9%），但对受累器官与原发性肿瘤进行根治性切除可将5年生存率提高至34%。每个原发部位和不同分期的复发模式明显不同。Dukes分期是总体预后的最重要决定因素。
