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结直肠癌肝转移灶肝切除术后的预后因素。

Prognostic factors following liver resection for hepatic metastases from colorectal cancer.

作者信息

Seifert J K, Böttger T C, Weigel T F, Gönner U, Junginger T

机构信息

Department of Surgery, University Hospital, Johannes Gutenberg-University, Mainz, Germany.

出版信息

Hepatogastroenterology. 2000 Jan-Feb;47(31):239-46.

Abstract

BACKGROUND/AIMS: We aimed to identify prognostic factors that may allow better patient selection for liver resection for colorectal liver metastases.

METHODOLOGY

A retrospective analysis of the files of 120 patients undergoing liver resection for colorectal metastases between 9/85 and 12/96 was performed. Survival and disease-free survival were calculated, and a uni- and multivariate analysis for the prognostic impact of various perioperative factors on survival was performed.

RESULTS

Perioperative morbidity and mortality were 28.3% and 5.8% respectively. Median overall survival was 30 months with a 5-year survival rate of 31%. Radicality was the prime prognostic determinant. In patients with R0-resection, a liver metastasis of > 3.5 cm in diameter was the only independent factor associated with an adverse prognosis.

CONCLUSIONS

Liver resection for colorectal liver metastases should be attempted if complete resection with clear margins is feasible and may be especially beneficial in patients with small (< or = 3.5 cm) lesions.

摘要

背景/目的:我们旨在确定可有助于更好地选择接受结直肠癌肝转移灶肝切除手术患者的预后因素。

方法

对1985年9月至1996年12月期间120例接受结直肠癌肝转移灶肝切除手术患者的病历进行回顾性分析。计算生存率和无病生存率,并对各种围手术期因素对生存的预后影响进行单因素和多因素分析。

结果

围手术期发病率和死亡率分别为28.3%和5.8%。中位总生存期为30个月,5年生存率为31%。根治性是主要的预后决定因素。在R0切除的患者中,直径>3.5 cm的肝转移灶是唯一与不良预后相关的独立因素。

结论

如果可行的话,应尝试对结直肠癌肝转移灶进行肝切除,切缘清晰的完全切除可能对小(≤3.5 cm)病灶患者特别有益。

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