Teh C S C, Ooi L L P J
Department of General Surgery, Singapore General Hospital.
Ann Acad Med Singap. 2003 Mar;32(2):196-204.
To review and evaluate trends for short and long-term outcomes of patients who have undergone liver resection for colorectal metastases in a single institution over a period of 7 years.
A retrospective review and analysis of clinicopathologic data and outcome of potentially curative liver resection for colorectal metastases in a series of 96 patients from January 1994 to December 2001 was done. Data were statistically analysed. Perioperative mortality, morbidity, overall survival and disease-free survival rates were reported.
A total of 96 patients underwent potentially curative liver resection for colorectal metastases. There were 64 males (66.7%) and 32 females (33.3%) with a median age of 60 years. There was no perioperative mortality. Postoperative morbidity was 7.2%. The median length of follow-up for the entire cohort of post hepatic resection was 29 months with 1-year and 3-year overall survival rates of 99% and 71%, respectively. The disease-free survival rates were 76% and 48%, respectively. Minor resections for the liver metastases showed significantly better overall survival. Primary tumour in the colon compared to rectum, disease-free interval (DFI) < 12 months and adjuvant chemotherapy showed a trend towards shorter overall survival. Carcinoembryonic antigen (CEA) levels greater than 100 ng/mL significantly shortens the disease-free survival.
Liver resection for colorectal metastases in our institution is a safe and effective treatment option in properly selected patients, which currently represents the best chance for long-term survival and possibly "cure".
回顾并评估在单一机构中,7年间接受肝切除治疗结直肠癌肝转移患者的短期和长期预后趋势。
对1994年1月至2001年12月期间96例接受潜在根治性肝切除治疗结直肠癌肝转移患者的临床病理数据及预后进行回顾性分析。对数据进行统计学分析。报告围手术期死亡率、发病率、总生存率和无病生存率。
共有96例患者接受了潜在根治性肝切除治疗结直肠癌肝转移。其中男性64例(66.7%),女性32例(33.3%),中位年龄60岁。无围手术期死亡。术后发病率为7.2%。肝切除术后整个队列的中位随访时间为29个月,1年和3年总生存率分别为99%和71%。无病生存率分别为76%和48%。肝转移的小范围切除显示出显著更好的总生存率。与直肠癌相比,结肠癌的原发肿瘤、无病间期(DFI)<12个月以及辅助化疗显示出总生存时间缩短的趋势。癌胚抗原(CEA)水平大于100 ng/mL显著缩短无病生存期。
在我们机构中,对经过适当选择的患者而言,肝切除治疗结直肠癌肝转移是一种安全有效的治疗选择,目前是实现长期生存乃至可能“治愈”的最佳机会。