Wood C B, Gillis C R, Hole D, Malcolm A J, Blumgart L H
Br J Surg. 1981 May;68(5):326-8. doi: 10.1002/bjs.1800680512.
A prospective study was carried out of 404 patients with colorectal cancer who were followed up for a mean period of 42 months. Macroscopic extramural tumour invasion was found at laparotomy in 46 patients undergoing apparently curative surgery and the survival rate was significantly reduced in these patients. The site of primary tumour in the colon or rectum did not influence the incidence of local tumour spread, but local invasion was related to the incidence of lymph node metastases and histological grading of the tumour. A staging classification has been proposed based not on lymphatic metastases, but on the extent of local tumour penetration. This modified staging system combines the operative findings with pathological grading of the tumour and emphasizes the prognostic significance of local tumour invasion.
对404例结肠癌患者进行了一项前瞻性研究，平均随访42个月。在接受根治性手术的46例患者中，剖腹手术时发现有肉眼可见的壁外肿瘤侵犯，这些患者的生存率显著降低。结肠或直肠原发性肿瘤的部位不影响局部肿瘤扩散的发生率，但局部侵犯与淋巴结转移发生率及肿瘤组织学分级有关。已提出一种分期分类方法，该方法不是基于淋巴转移，而是基于局部肿瘤浸润的程度。这种改良的分期系统将手术所见与肿瘤的病理分级相结合，并强调局部肿瘤侵犯的预后意义。
