Willett C G, Tepper J E, Cohen A M, Orlow E, Welch C E
Ann Surg. 1984 Dec;200(6):685-90. doi: 10.1097/00000658-198412000-00001.
To identify patterns of failure following curative resection of colonic (nonrectal) carcinoma, the medical records of 533 patients undergoing resection with curative intent were reviewed. The overall local failure rate was 19% (102/533 patients) with 32 patients having local failure alone and 70 patients having concurrent local failure and distant metastases. The incidence of local failure rose with advancing stage of disease. Tumors staged B3, C2, and C3 had local failure rates in excess of 30%. Local failures occurred predominantly in tumor bed and adjoining structures (82%) and not by regional nodal failure (18%). One hundred thirty-one patients (25%) developed distant metastases. One hundred ten patients (84%) failed in the abdomen-liver, peritoneal seeding, para-aortic, or portahepatic lymph nodes. Patients with Stage B3, C2, and C3 tumors were found to have abdominal failure rates (excluding local failure) of greater than 20%. The highest failure rates in the liver were in Stage C2 and C3 patients in which the subsequent development of liver metastases was 29% and 31%, respectively. In Stage C3, peritoneal seeding and abdominal lymph node failure occurred in 18% and 14% of the patients, respectively.
为了确定结肠癌（非直肠癌）根治性切除术后的失败模式，我们回顾了533例接受根治性切除手术患者的病历。总体局部失败率为19%（102/533例患者），其中32例患者仅出现局部失败，70例患者同时出现局部失败和远处转移。局部失败的发生率随着疾病分期的进展而升高。B3期、C2期和C3期肿瘤的局部失败率超过30%。局部失败主要发生在肿瘤床和相邻结构（82%），而非区域淋巴结失败（18%）。131例患者（25%）发生远处转移。110例患者（84%）在腹部-肝脏、腹膜种植、腹主动脉旁或肝门淋巴结处出现失败。发现B3期、C2期和C3期肿瘤患者的腹部失败率（不包括局部失败）大于20%。肝脏中失败率最高的是C2期和C3期患者，其随后发生肝转移的比例分别为29%和31%。在C3期，18%的患者发生腹膜种植，14%的患者发生腹部淋巴结失败。
