Tsuji Yasushige, Hamada Hiromi, Yasuda Daisuke, Okamura Mikio, Watanabe Kazunori, Takahashi Toru, Takada Joji, Katsuki Yoshio
Dept. of Surgery, Nikko Memorial Hospital.
Gan To Kagaku Ryoho. 2002 Nov;29(12):2100-3.
Of 66 examples of hepatic metastases from colorectal cancer, 30 cases in which resection was performed had 3- and 5-year cumulative survival rates of 66.7% and 56.8%, while in 36 cases in which resection was not possible, the percentages were 8.7% and 2.9%, respectively. In two of the latter cases, resection was possible following WHF (5-FU 1,000 mg/m2 5 h qw). Case 1: A 58-year-old male, with rectal cancer and multiple metastases (H3, synchronous). Arterial infusion was performed 21 times, with the total volume of 5-FU administered being 31.5 g. The size of the lesions was reduced and hepatic resection was performed. The patient later died due to local recurrence and intra-abdominal lymph node metastases. He had survived 2 years and 11 months following hepatic resection and was free from recurrence of hepatic metastases. Case 2: An 82-year-old female, with cancer of the ascending colon, sigmoidal colon and multiple hepatic metastases (H3, metachronous). Arterial infusion was performed 16 times, with the total amount of 5-FU administered being 20 g. A lowering of CEA levels and reduction of tumor size were achieved, and hepatic resection was performed. Seven months following hepatic resection, CEA levels are normal and no distant metastases or recurrence in the residual liver have been found: possibly a complete cure. Even among cases of unresectable hepatic metastases from colorectal cancer, there are some in which resection is possible following hepatic arterial infusion chemotherapy, with the possibility of complete cure.
在66例结直肠癌肝转移病例中，30例行切除术的患者3年和5年累积生存率分别为66.7%和56.8%，而36例无法行切除术的患者，这两个比例分别为8.7%和2.9%。在后一组病例中有2例，在进行肝动脉灌注化疗（5-氟尿嘧啶1000mg/m²，持续5小时，每周1次）后可行切除术。病例1：一名58岁男性，患有直肠癌并多发转移（H3，同时性）。进行了21次动脉灌注，5-氟尿嘧啶的总给药量为31.5g。病灶缩小后进行了肝切除术。患者后来因局部复发和腹腔内淋巴结转移死亡。肝切除术后存活了2年11个月，肝转移未复发。病例2：一名82岁女性，患有升结肠癌、乙状结肠癌并多发肝转移（H3，异时性）。进行了16次动脉灌注，5-氟尿嘧啶的总给药量为20g。癌胚抗原（CEA）水平降低，肿瘤缩小，随后进行了肝切除术。肝切除术后7个月，CEA水平正常，未发现远处转移或残留肝脏复发：可能已完全治愈。即使在结直肠癌不可切除的肝转移病例中，也有一些患者在肝动脉灌注化疗后可行切除术，并有完全治愈的可能。
