Summary
In this study the incidence of recurrence in radical procedure for carcinoma of colon is more than 37.4%. Of 100 patients undergoing second laparotomy because of recurrence 33% could be resected curatively. The rate of recurrence was independent on sex, negatively correlated with age and positively correlated with tumor stage of former operations. Curative operations located at the ascending colon and hepatic flexure had less recurrences than others. Second operations in curative aims were twice as successfull in men than in woman and equally possible in all decades. Results of recurrences of splenic flexure and transverse colon were better than other locations. Tumors of early stages relapsed later. The probability of a radical procedure in recurrence related operations was better in those cases with a long recurrence-free interval. The resectability ± rate and tumor stage of second-look operation were depending on tumor stage in the first operation. This means further history of tumor disease is determined closely by tumor stage in the first operation.
Zusammenfassung
Die Rezidivrate nach radikaler Operation wegen Coloncarcinom ist in unserem Krankengut mit höher als 37,4% zu veranschlagen. Von 100 operativ therapierten Rezidiven konnten 33% noch einmal in kurativem Sinne reseziert werden. Die Rezidivrate erwies sich als unabhängig von Geschlecht, negativ korreliert mit dem Alter, und positiv korreliert mit dem Tumorstadium beim ersten Eingriff. Kurative Eingriffe am Colon ascendens und der rechten Flexur zogen Rezidive an geringer Zahl nach sich. Kurative Rezidiveingriffe waren an Männern, bezogen auf die Rezidivrate, doppelt so hoch als an Frauen und über alle Altersstufen gleichermaßen durchführbar. Die linke Flexur und das Colon transversum erwiesen sich als günstige Lokalisationen im Hinblick auf radikale Zweiteingriffe. Tumoren in frühen Stadien zeigen eine späte Rezidivneigung. Die Wahrscheinlichkeit eines radikalen Zweiteingriffes wuchs mit dem Abstand vom ersten Eingriff. Die Radikalität des Zweiteingriffes bzw. das Tumorstadium bei Rezidivoperationen erwiesen sich als direkt abhängig vom Tumorstadium beim Ersteingriff. Somit wird der weitere Verlauf eines Tumorleidens vom Tumorstadium beim Ersteingriff determiniert.
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Mentges, B., Stahlschmidt, M. & Brückner, R. Das Rezidivproblem beim Coloncarcinom. Langenbecks Arch Chiv 367, 51–62 (1985). https://doi.org/10.1007/BF01241945
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DOI: https://doi.org/10.1007/BF01241945