Norberg K A, Emås S
Am J Surg. 1981 Nov;142(5):569-73. doi: 10.1016/0002-9610(81)90428-1.
In our department of surgery 28 patients with malignant and 10 with benign tumors of the small intestine were treated from 1940 to 1974. Fifteen patients with malignant and 7 with benign tumors underwent surgery with the intention to cure. Palliative operations or explorations were carried out on 13 patients with malignant tumors. Three patients with benign tumors were not operated on. The initial symptoms were vague: abdominal pain, nausea, anemia or bleeding in 75 and 80 percent of patients with malignant and benign tumors, respectively. The indication for operation in the malignant cases was, however, stenosis of the intestine or biliary tract or a palpable mass in 60 percent of the cases. At operation the tumors were thus in an advanced stage. Because the initial symptoms are vague, early diagnosis is difficult. The overall 5 year survival rate was 21 percent after surgery for malignant tumors. Among the patients considered by the surgeons to have had radical operations excluding cancer patients, 40 percent survived 5 years. The surgeon's opinion regarding "radical" operation as well as the presence or absence of metastases at microscopy were of limited prognostic value.
1940年至1974年间，我们外科共治疗了28例小肠恶性肿瘤患者和10例小肠良性肿瘤患者。15例恶性肿瘤患者和7例良性肿瘤患者接受了旨在治愈的手术。对13例恶性肿瘤患者进行了姑息性手术或探查。3例良性肿瘤患者未接受手术。初始症状不明确：恶性肿瘤患者和良性肿瘤患者中分别有75%和80%出现腹痛、恶心、贫血或出血症状。然而，60%的恶性肿瘤病例的手术指征是肠道或胆道狭窄或可触及肿块。因此，手术时肿瘤已处于晚期。由于初始症状不明确，早期诊断困难。恶性肿瘤手术后的总体5年生存率为21%。在外科医生认为接受了根治性手术（不包括癌症患者）的患者中，40%存活了5年。外科医生对“根治性”手术的看法以及显微镜下是否存在转移的预后价值有限。
