Herfarth C, Hohenberger P
Chirurgische Universitätsklinik, Heidelberg.
Langenbecks Arch Chir Suppl Kongressbd. 1992:66-72.
From 1981 to 1991, 161 patients underwent liver resection for colorectal secondaries with curative intent. In 57 patients metastases were synchronous to the primary tumor and were resected in 29 cases simultaneously and in 28 patients after a 2-week delay. Median survival of 28 months is similar to the treatment result for metachronous metastases. However, the recurrence-free interval was significantly shorter (7.5 months vs 11.8 months; p = 0.05). Radical resection of the primary tumor contributes to the treatment result; segmental resections of colorectum without lymphadenectomy should be avoided. Indication for liver resection should be made in the case of solitary lesions and in patients without extrahepatic disease. The type of resection for the primary tumor or for liver metastases does not influence survival, morbidity, or operative mortality.
1981年至1991年期间,161例患者接受了旨在根治的结直肠癌肝转移灶切除术。57例患者的转移灶与原发肿瘤同时出现,其中29例在同期进行了切除,28例在延迟2周后进行了切除。28个月的中位生存期与异时性转移的治疗结果相似。然而,无复发生存期明显较短(7.5个月对11.8个月;p = 0.05)。原发肿瘤的根治性切除有助于治疗效果;应避免不进行淋巴结清扫的结直肠节段性切除。对于孤立性病变且无肝外疾病的患者,应考虑进行肝切除。原发肿瘤或肝转移灶的切除类型不影响生存率、发病率或手术死亡率。