Lehnert T, Knaebel H P, Dück M, Bülzebruck H, Herfarth C
Department of Surgery, University of Heidelberg, Germany.
Br J Surg. 1999 Feb;86(2):241-3. doi: 10.1046/j.1365-2168.1999.01010.x.
Resection of pulmonary or hepatic colorectal metastases is associated with a 5-year survival rate of 25-40 per cent. This report analyses outcome following sequential resection of colorectal metastases to both organs.
Seventeen patients with histologically confirmed colorectal adenocarcinoma and resection of liver and lung metastases were identified from a prospective database.
The median interval between resection of the primary tumour and first metastasis was 21 (range 0-64) months. The interval between resection of the first and subsequent metastases was 18 (range 1-74) months. No patient died in the postoperative period and there were two perioperative complications. The overall survival rate in 17 patients was 70 per cent at 2 years from resection of metastasis to the second organ, but the disease-free survival rate at 2 years was only 24 per cent.
Although few long-term survivors were observed in this small series, sequential resection of hepatic and pulmonary metastases is warranted in a highly selected group of patients.
肺或肝结直肠癌转移灶切除术后的5年生存率为25% - 40%。本报告分析了结直肠癌转移灶先后切除至两个器官后的结局。
从一个前瞻性数据库中识别出17例经组织学确诊为结直肠腺癌且已切除肝和肺转移灶的患者。
原发肿瘤切除与首次转移之间的中位间隔时间为21（范围0 - 64）个月。首次转移与后续转移切除之间的间隔时间为18（范围1 - 74）个月。无患者在术后死亡，围手术期有2例并发症。从转移灶切除至第二个器官起2年时，17例患者的总生存率为70%，但2年无病生存率仅为24%。
尽管在这个小系列中观察到的长期存活者很少，但对于经过严格挑选的一组患者，肝和肺转移灶的序贯切除是必要的。
