| 特集名 | 直腸癌の解明に向けて --結腸癌との対比から | |
|---|---|---|
| 題名 | 直腸癌の臨床病理学的特徴像 --結腸癌との対比から (2) 進行癌を中心に | |
| 発刊年月 | 2000年 09月 | |
| 著者 | 加藤 知行 | 愛知県がんセンター消化器外科部 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Elucidation of the pathogenesis of rectal carcinoma with special reference to colonic carcinoma | |
|---|---|---|
| Title | Clinico-pathological characteristics of advanced rectal cancer | |
| Author | Tomoyuki Kato | Gastroenterological Surgery, Aichi Cancer Center Hospital |
| [ Summary ] | Clinico-pathological characteristics of advanced rectal cancer were described and compared with those of colon cancer. The number of large bowel cancer is increasing every year. The frequency of colon cancer has increased, and that of lower rectal cancer has decreased. The frequency of patients under 40 years old has decreased, and that of older patients (over 75 years) has increased. From 1985 to 1994, 1,147 patients received surgical treatment for large bowel cancer. There were 523 patients with rectal cancer, 624 with colon cancer, one with anal cancer and one with cancer of the appendix. 445 of 523 rectal cancer patients and 507 of 624 colon cancer patients had advanced cancer. 359 patients (80.7%) of advanced rectal cancer patients received curative resection. The rate of curative resection for rectal cancer was higher than that for colon cancer. The liver was the most frequent site of metastasis in both rectal cancer and colon cancer. The five-year survival rate for non-curative resection of rectal cancer was 10.7% and that for colon cancer was 9.8%. There were no survivors over five years in nonresected patients. The five-year survival rate for rectal cancer after curative resection was 97.1% in stage I, 85.6% in stage II, 71.9% in stage IIIa and 56.7% in stage IIIb, while in colon cancer it was 95.7% in stage I, 93.7% in stage II, 85.8% in stage IIIa and 71.7% in stage IIIb. Major recurrent sites after curative rectal resection were the liver in 6.4% of patients, lung in 5.8% and pelvis in 7.5%. Those for colon cancer were liver 5.9% and lung 2.9%. We have concluded that higher pelvic recurrence rates and higher lung recurrence rates for rectal cancer with curative resection makes the five-year survival rate worse compared with rates of colon cancer. The difference of pathologic findings, including pathologic type, lymphatic permeation, venous invasin and INF between rectal cancer and colon cancer has been discussed. |
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