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TNMⅢ期结肠直肠癌的预后变异很大,其5年生存率在22%～66%之间.已有根据肿瘤穿透深度或转移淋巴结数目将Ⅲ期分成几个亚期的分类分法.作者回顾性分析1980～1989年所施行治愈性切除的538例TNMⅢ期结肠直肠癌病例,平均年龄54±13岁,54%为男性,286例系直肠癌,252例系结肠癌.区域淋巴结检查数17.4士7.8个(10～41个),其中阳性为 5.4±5.2个.淋巴结转移数1～3个为N_1,4个或更多为N_2,沿血管干全部淋巴结转移为N_3,则pN_1占47%,pN_2占38%,pN_3占15%.平均随访44月(6～153月),5年和10年生存率分别为52%和42%.在单因素分析中,肿瘤形态学、肿瘤穿透深度、组织学分级、淋巴结受侵数及其平面具有判断预后的重要意义;但在多因素分析中,仅组织学分级和淋巴结状态(受侵数及其平面)具有重要意义.
The prognosis of TNM stage III colorectal cancer is very variable. The 5-year survival rate is between 22% and 66%. According to the depth of tumor penetration or the number of metastatic lymph nodes, stage III is divided into several sub-stages. We retrospectively analyzed 538 cases of TNM III colorectal cancer who underwent curative resection from 1980 to 1989. The average age was 54±13 years, 54% were male, 286 cases were rectal cancer, and 252 cases were colon cancer. Regional lymph node examinations 17.4 ± 7.8 (10 to 41), of which 5.4 ± 5.2 were positive. The number of lymph node metastases was 1 to 3 N_1, 4 or more were N_2, and the total lymph node metastasis along the vessel was N_3, then pN_1 accounted for 47%. %, pN_2 accounted for 38%, pN_3 accounted for 15%. The average follow-up of 44 months (6 to 153 months), 5-year and 10-year survival rates were 52% and 42%. In univariate analysis, tumor morphology, tumor wear Penetration depth, histological grade, lymph node invasion number, and plane are important for predicting prognosis. However, in multivariate analysis, only histological grade and lymph node status (invasion number and plane) are of great significance.