Takahashi Shinichiro, Konishi Masaru, Nakagohri Toshio, Gotohda Naoto, Saito Norio, Kinoshita Taira
Department of Surgery, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan.
Jpn J Clin Oncol. 2006 Jun;36(6):368-75. doi: 10.1093/jjco/hyl027. Epub 2006 Jun 8.
Early recurrence is a major problem after hepatic resection of colorectal hepatic metastasis (CHM). Our aim was to investigate the relationship between time to recurrence after CHM resection and overall survival.
A retrospective analysis was performed for 101 consecutive patients who underwent hepatic resection for CHM and have been followed more than 5 years.
Among 101 patients, 82 (81%) had a recurrence. Overall survival of patients with recurrence within 6 months after CHM resection was significantly worse than that of patients with recurrence after more than 6 months (P < 0.01). Overall survival was poorer when time to recurrence was shorter. One of the reasons for poor prognosis of patients with recurrence within 6 months was that only a few patients could undergo a second resection for recurrence after CHM resection. Histological type, including poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor, bilobar metastases, microscopic positive surgical margin and carcinoembryonic antigen (CEA) above 15 ng/ml had predictive value for decreased recurrence-free survival after CHM resection.
Short time to recurrence after CHM resection correlates with a poor prognosis. Histological type of poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor might be a predictor for early recurrence after CHM resection.
早期复发是结直肠癌肝转移（CHM）肝切除术后的一个主要问题。我们的目的是研究CHM切除术后复发时间与总生存期之间的关系。
对101例连续接受CHM肝切除术且随访超过5年的患者进行回顾性分析。
101例患者中，82例（81%）出现复发。CHM切除术后6个月内复发患者的总生存期明显差于6个月后复发的患者（P<0.01）。复发时间越短，总生存期越差。CHM切除术后6个月内复发患者预后不良的原因之一是只有少数患者能够接受复发后的二次切除。组织学类型，包括原发肿瘤中低分化印戒细胞或黏液腺癌、双叶转移、显微镜下手术切缘阳性以及癌胚抗原（CEA）高于15 ng/ml对CHM切除术后无复发生存期缩短具有预测价值。
CHM切除术后复发时间短与预后不良相关。原发肿瘤中低分化印戒细胞或黏液腺癌的组织学类型可能是CHM切除术后早期复发的一个预测指标。
