Nagakura S, Shirai Y, Hatakeyama K
Department of Surgery, Niigata University School of Medicine, 1-757 Asahimachi-dori, Niigata City, 951-8510 Japan.
Dis Colon Rectum. 2001 Aug;44(8):1148-54. doi: 10.1007/BF02234637.
The gross appearance of colorectal carcinoma liver metastases reflects the biologic behavior of the tumor, yielding prognostic information. The aims of this retrospective study were to determine whether preoperative computed tomographic features of colorectal carcinoma liver metastases reflect the gross appearance of resected specimens and whether these computed tomographic hepatic features predict survival after hepatectomy.
Eighty-five patients underwent curative partial hepatectomy for colorectal carcinoma liver metastases. Preoperative computed tomographic features of the largest hepatic deposit were classified by the contour of advancing margin of the tumor into two types: lobular tumors with indentations with an acute angle and nonlobular tumors without such indentations. The correlation between computed tomographic features and 18 other clinicopathologic factors was examined.
The overall five-year survival rate was 34.1 percent. Of 85 hepatic tumors examined, 49 were lobular and 36 were nonlobular. Computed tomographic features correlated significantly with gross appearance (P = 0.007). Univariate analysis revealed that computed tomographic features (P < 0.0001), gross appearance (P = 0.0063), size of the largest hepatic deposit (P = 0.0075), age (P = 0.0140), and satellite lesions (P = 0.0443) were significant prognosticators. The five-year survival rates in patients with lobular and nonlobular tumors were 10.4 and 66.1 percent, respectively. By multivariate analysis, computed tomographic features (P < 0.0001) and size of the largest hepatic deposit (P = 0.0419) were independently significant.
Computed tomographic features of colorectal carcinoma liver metastases correlate with their gross appearance. The computed tomographic characterization of liver metastases is the most important independent prognostic factor in patients undergoing curative hepatectomy.
结直肠癌肝转移灶的大体外观反映肿瘤的生物学行为，可提供预后信息。本回顾性研究的目的是确定结直肠癌肝转移灶的术前计算机断层扫描（CT）特征是否反映切除标本的大体外观，以及这些CT肝脏特征是否能预测肝切除术后的生存情况。
85例患者因结直肠癌肝转移接受了根治性肝部分切除术。根据肿瘤前缘的轮廓，将最大肝转移灶的术前CT特征分为两类：有锐角切迹的小叶状肿瘤和无此类切迹的非小叶状肿瘤。研究了CT特征与其他18种临床病理因素之间的相关性。
总体五年生存率为34.1%。在检查的85个肝肿瘤中，49个为小叶状，36个为非小叶状。CT特征与大体外观显著相关（P = 0.007）。单因素分析显示，CT特征（P < 0.0001）、大体外观（P = 0.0063）、最大肝转移灶大小（P = 0.0075）、年龄（P = 0.0140）和卫星灶（P = 0.0443）是显著的预后因素。小叶状和非小叶状肿瘤患者的五年生存率分别为10.4%和66.1%。多因素分析显示，CT特征（P < 0.0001）和最大肝转移灶大小（P = 0.0419）具有独立显著性。
结直肠癌肝转移灶的CT特征与其大体外观相关。肝转移灶的CT特征是接受根治性肝切除术患者最重要的独立预后因素。
