大腸多発癌の臨床病理学的検討

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  • Clinicopathological study on multiple colorectal cancer.

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Of 339 patients who underwent surgery for colorectal carcinoma during the past 17 years, 27 (8.0%) had multiple lesions. The multiple growth was synchronous in 20 (5.9%) and metachronous in 7 (2.1%). The average interval of the metachronous occurrences was 54 months. The average ages of the patients were 64.2 and 50.4 years at surgery for the synchronous and first metachronous lesions, respectively. Synchronous lesions frequently occurred in the distal large bowel, and multiple lesions were often found in close proximity to each other. Histologically, the tumors were diagnosed as more advanced than the pm stage, in 75.0% and 85.7% of first synchronous and metachronous lesions, respectively. However 65.0% of second synchronous lesions showed a degree of penetration less than that defined as pm. Curative surgery was successfully performed in 60.0% of synchronous cases, among which 5-year survival rate of 57.1% was achieved. With the metachronous cases, the first lesion was successfully eradicated in 71.4%, and the 5-year survival rate was 100%. Thus, the importance of accurate preoperative diagnosis and periodic follow-up examination was suggested.

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