McDermott F T, Hughes E S, Pihl E A, Milne B J, Price A B
Aust N Z J Surg. 1984 Feb;54(1):53-8. doi: 10.1111/j.1445-2197.1984.tb06685.x.
The influence of differentiation grade on tumour staging, local recurrence and long term survival prospects has been evaluated in a series of patients managed by resection for rectal cancer. Differentiation was known in 1095 of 1296 patients. Well-differentiated tumours were over-represented among Dukes' stage A cases and poorly differentiated among those with disseminated disease (P less than 0.001). Local recurrence was twice as common (31%) after curative resection of poorly differentiated tumours than of well (14%) or moderately (17%) differentiated. Five year cancer specific survival rates after resection (curative and palliative combined) of tumours of good, average or poor differentiation were 68%, 59% and 33%, respectively. After potentially curative resection, survival was also significantly worse in patients with poorly differentiated tumours (P less than 0.001); 5 year survival rates of patients with tumours of good, average or poor differentiation were 75%, 71% and 51%, respectively. Survival prospects beyond 5 years in patients with Dukes' stage A tumours were significantly reduced when the tumour was poorly differentiated; 5 and 10 year survival rates were 76% and 40%, respectively. However, patients with Dukes' stage C tumours of poor differentiation had an identical 5 and 10 year cancer specific survival, 26%. Patients with mucoid type tumours had worse survival prospects than those with non-mucoid type (P less than 0.02).
在一系列接受直肠癌切除术治疗的患者中，评估了分化程度对肿瘤分期、局部复发和长期生存前景的影响。1296例患者中有1095例已知分化情况。高分化肿瘤在Dukes A期病例中占比过高，而在有播散性疾病的病例中低分化肿瘤占比过高（P<0.001）。低分化肿瘤根治性切除术后局部复发的发生率（31%）是高分化（14%）或中分化（17%）肿瘤的两倍。高分化、中等分化或低分化肿瘤切除术后（根治性和姑息性联合）的五年癌症特异性生存率分别为68%、59%和33%。在可能根治性切除术后，低分化肿瘤患者的生存率也显著更差（P<0.001）；高分化、中等分化或低分化肿瘤患者的五年生存率分别为75%、71%和51%。当肿瘤为低分化时，Dukes A期肿瘤患者超过5年的生存前景显著降低；5年和10年生存率分别为76%和40%。然而，低分化的Dukes C期肿瘤患者的5年和10年癌症特异性生存率相同，均为26%。黏液型肿瘤患者的生存前景比非黏液型患者更差（P<0.02）。
