大腸癌の臨床・病理学的動向 ： 当教室における過去18年間の大腸癌症例の検討

Abstract

Statistical examinations were performed on clinico-pathological factors of 505 primary colorectal cancer cases treated at the First Department of Surgery of Nara Medical University during 18 years (from April, 1972 to March, 1990). They were divided in two groups : one is the first term group which consists of cases between April, 1972 and March, 1982. and the other is the latter term group between April, 1982 and March, 1990. Clinico-pathological trends were studied by comparing the two groups. The results were as follows. 1. The average number of annual cases in the latter term increased 1.6 times compared with that in the first term. 2. The sexual difference of colorectal cancers decreased from 1.6 (male/female) to 1.3. 3. The ratio of the rectum/colon also decreased from 1.6 to 0.93. This change was more significant in females (from 1.96 to 1.05). This result suggests the relative increase of colonic cancer in females. 4. Regarding the distribution of the location, sigmoid colon increased and middle and lower rectum decreased (from 15.8% to 25.9%, 27% to 15.1%, 28.6% to 22.4%, respectively). But in the other portions there was no significant change. So the ratios of sigmoid colon and rectum/whole large intestine were even in both periods. 5. The ratio of curative operation was about 75% at the latter term. There were many reasons for non-curative operations including liver metastasis, peritoneal disseminations and metastasis to other organs except liver (colon cases 22%, rectal cases 8.5%). Especially the liver metastasis occurred in 54% of non-curatively operated colon cancers and 61% of rectal cancers.