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01121 Journal of Nara Medical Association >
Vol.43 No.3 >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/1903

Title: 教室における大腸癌症例の検討-第二報 : 手術成績および遠隔治療成績
Authors: 仲川, 昌之
藤井, 久男
山本, 克彦
佐道, 三郎
山本, 雅敏
渡邉, 巌
安田, 慎治
吉川, 周作
中嶋, 寿
内藤, 梓
中野, 博重
Keywords: colorectal cancer
surgical outcome
Issue Date: 30-Jun-1992
Publisher: 奈良医学会
Citation: 奈良医学雑誌 Vol.43 No.3 p.195-206
Abstract: During the 18-year period from 1972 through 1990, 498 patients were admitted to our clinic for colorectal cancer. Dividing the patients into two groups (one included the cases of the first 10-year period which were mainly operated with "R2" lymphnode cleaning, and the another included cases of the latter 8 years with "R3" lymphnode cleaning), we evaluated the variation of the outcome of surgical treatment comparing the results of the two periods. The results were as follows : 1. The resection rates were elevated in both colonic and rectal cancer (82.5% to 98.6% and 89.5% to 95.8%, respectively). The curative resection rates also increased (colon : from 56.3% to 77.3%, rectum : from 74.6% to 86.6%) 2. The surgical mortality rates decreased from 2.6% to 0.8%. 3. Noncurative resections were caused by hepatic metastasis (61%), peritoneal dissemination (26%), distant metastasis excluding the liver (11.8%), locally far advanced extension (11.8%) and exceeding spread of lymphnode metastasis (10.5%) 4. The overall 5-year survival rates increased in colonic and rectal cancer (52.5% to 64.3% and 40.8% to 67.3%, respectively), and also improved with regard to curatively operated cases (73.4% to 78.6% and 54.5% to 81.9%, respectively). The survival rates by Dukes' classification revealed improvement in Dukes B and C of rectal cancer cases. According to stage classification, stage Ⅲ and Ⅳ had changes for the better. 5. Recurrences of curatively resected cases occurred in 83.3% within 2 years after primary operations, but no reccurrence was recognized in those cases after 5 years. 6. The incidence of sphincter saving operations for lower rectal cancer ("Ra-Rb") was elevated from 11.4% to 35.1%. The survival rates showed no significant difference between sphincter saving operation and abdominoperoneal resection in both periods.
URI: http://hdl.handle.net/10564/1903
ISSN: 04695550
Appears in Collections:Vol.43 No.3

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