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自从六十年代后期证明氟脲嘧啶有肯定但较轻的疗效后,对结直肠癌(CRC)附加全身治疗已在观念上被普遍接受。三十多年来唯一最迫切的争论就是切除后5年生存率始终维持在45%至50%不变,尽管CRC发病率在增加,诊断、手术及病理分期技术有所改进。1990年美国国立健康研究所分析多中心的有对照的前瞻性辅助试验。试验结果可以回答三个问题。(1)CRC切除后谁有最大的复发危险性?(2)有没有对CRC的有效辅助疗法?(3)这些资料如何用来改变手术技术?
Since the late 1960s demonstrated that fluorouracil has a positive but lesser effect, systemic treatment of colorectal cancer (CRC) has been generally accepted conceptually. The single most pressing argument in more than thirty years is that the 5-year survival rate has remained unchanged from 45% to 50% after resection. Although the incidence of CRC is increasing, the diagnostic, surgical and pathological staging techniques have improved. In 1990, the National Institutes of Health in the United States analyzed multicenter, controlled, prospective adjuvant trials. The test results can answer three questions. (1) Who has the greatest risk of recurrence after CRC resection? (2) Is there an effective adjuvant therapy for CRC? (3) How are these data used to alter surgical techniques?