Nakahashi Chigusa, Oda Tatsuya, Kinoshita Taira, Ueda Takanori, Konishi Masaru, Nakagohri Toshio, Inoue Kazuto, Furuse Junji, Ochiai Atsushi, Ohkohchi Nobuhiro
Hepato-Biliary-Pancreatic Division, National Cancer Center Hospital East, Chiba, Japan.
Int J Gastrointest Cancer. 2003;33(2-3):155-64. doi: 10.1385/IJGC:33:2-3:155.
Liver metastases are frequent in pancreatic cancer, although their impact on patient mortality is still unclear.
The extent of liver metastasis (H-III [diffuse], H-II [moderate], H-I [limited], H-0) and the magnitude of liver dysfunction (lf-III [failure], lf-II [severe], lf-I [moderate], lf-0) were reviewed in 89 locally advanced and resectable pancreatic cancer patients in order to determine possible relationships with mortality and survival.
The extent of liver metastasis (H-III, 18; H-II, 20; H-I, 12; H-0, 39) and the magnitude of liver dysfunction (lf-III, 12; lf-II, 8; lf-I, 11; lf-0, 58) were quite variable. Based on the aforementioned two categories, pancreatic cancer patients could be divided into four groups: (A) extensive liver metastasis affecting patient mortality, 14% (12/89); (B) liver metastases that do not cause severe liver dysfunction, 38% (34/89); (C) severe liver dysfunction, not associated with liver metastasis, 9% (8/89); (D) spared liver function, with no liver metastasis, 39% (35/89). The median survival period of H-III patients (195 d) was quite short compared with those of H-I (288 d) and H-0 (240 d) patients.
Considering patients with locally advanced and resectable pancreatic cancer, the fraction of cases with diffuse liver metastases is relatively small. Moreover, only a minor proportion of pancreatic cancer patients die from hepatic failure as a direct result of liver metastasis.
尽管肝转移对胰腺癌患者死亡率的影响尚不清楚，但在胰腺癌中肝转移很常见。
回顾了89例局部晚期且可切除的胰腺癌患者的肝转移程度（H-III[弥漫性]、H-II[中度]、H-I[局限性]、H-0）和肝功能障碍程度（lf-III[衰竭]、lf-II[重度]、lf-I[中度]、lf-0），以确定其与死亡率和生存率的可能关系。
肝转移程度（H-III，18例；H-II，20例；H-I，12例；H-0，39例）和肝功能障碍程度（lf-III，12例；lf-II，8例；lf-I，11例；lf-0，58例）差异很大。基于上述两类，胰腺癌患者可分为四组：（A）广泛肝转移影响患者死亡率，14%（12/89）；（B）肝转移未导致严重肝功能障碍，38%（34/89）；（C）严重肝功能障碍，与肝转移无关，9%（8/89）；（D）肝功能未受影响，无肝转移，39%（35/89）。与H-I组（288天）和H-0组（240天）患者相比，H-III组患者的中位生存期（195天）相当短。
对于局部晚期且可切除的胰腺癌患者，弥漫性肝转移的病例比例相对较小。此外，只有一小部分胰腺癌患者因肝转移直接死于肝衰竭。
