120例结直肠癌肝转移患者切缘受累或切缘接近时的处理：边缘冷冻疗法可实现长期生存。
Management of involved or close resection margins in 120 patients with colorectal liver metastases: edge cryotherapy can achieve long-term survival.
作者信息
Yan Tristan D, Padang Ratnasari, Xia Hong, Zhao Jing, Li Jie, Morris David L
机构信息
University of New South Wales, Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia.
出版信息
Am J Surg. 2006 Jun;191(6):735-42. doi: 10.1016/j.amjsurg.2005.05.055.
BACKGROUND
The liver resection margin is prognostically significant for patients with colorectal liver metastases. Management plans for patients with suboptimal resection margins have not been adequately addressed. This article reports the long-term results of edge cryotherapy in 120 patients with suboptimal resection margins.
METHODS
A retrospective analysis of prospectively collected clinical data of 120 patients with suboptimal hepatic resection margins was performed. Morbidity, mortality, recurrence, and survival results were analyzed.
RESULTS
The median length follow-up was 30 months (range 1 to 139). The median disease-free interval was 19 months (range 2 to 139). Cryosite, remaining liver, and extrahepatic recurrence rates were 10%, 36%, and 47%, respectively. The median survival was 39 months (range 1 to 139), and 1-, 3-, and 5-year survival rates were 89%, 55%, and 36%, respectively. Cryosite and extrahepatic recurrence were independently associated with a reduced survival outcome.
COMMENTS
Edge cryotherapy to suboptimal liver resection margins can achieve a lower local recurrence rate and a longer survival advantage.
背景
肝切除切缘对结直肠癌肝转移患者的预后具有重要意义。对于切缘不理想的患者，其管理方案尚未得到充分探讨。本文报告了120例切缘不理想患者行边缘冷冻治疗的长期结果。
方法
对前瞻性收集的120例肝切除切缘不理想患者的临床数据进行回顾性分析。分析发病率、死亡率、复发率和生存结果。
结果
中位随访时间为30个月（范围1至139个月）。中位无病间期为19个月（范围2至- 139个月）。肝内复发、肝内残留和肝外复发率分别为10%、36%和47%。中位生存期为39个月（范围1至139个月），1年、3年和5年生存率分别为89%、55%和36%。肝内复发和肝外复发与生存结果降低独立相关。
评论
对切缘不理想的肝脏进行边缘冷冻治疗可实现较低的局部复发率和更长的生存优势。
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