Takahashi S, Konishi M, Nakagohri T, Gotohda N, Hanaoka T, Saito N, Kinoshita T
Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Chiba, Japan.
Eur J Surg Oncol. 2006 Dec;32(10):1195-200. doi: 10.1016/j.ejso.2006.08.002. Epub 2006 Sep 11.
The efficacy of surgical resection for multiple colorectal hepatic metastases (MCHM) has been controversial. We examined the survival of patients who received surgery for MCHM and examined the factors associated with survival.
A retrospective analysis was performed of 50 consecutive patients who received hepatic resections for MCHM, defined as four or more metastatic lesions of colorectal cancer.
Overall survival after hepatic resection for MCHM was 48% at 3years and 43% at 5years (median survival, 22.3months). Multivariate analyses revealed that a coefficient of variation (CV) in volume of hepatic metastases in each individual patient above 1.8 (P=0.01, HR=4.08, 95% CI=1.33-12.5) was the only poor prognostic factor after resection of MCHM.
A CV in volume of hepatic metastases in each individual patient above 1.8 predicts poor survival after hepatectomy of MCHM. Thus, the CV in volume of hepatic metastases in each individual patient might be useful in planning the therapeutic strategy for patients with MCHM.
手术切除多发性结直肠癌肝转移瘤（MCHM）的疗效一直存在争议。我们研究了接受MCHM手术患者的生存率，并分析了与生存相关的因素。
对连续50例接受肝切除治疗MCHM（定义为四个或更多结直肠癌转移灶）的患者进行回顾性分析。
MCHM肝切除术后3年总生存率为48%，5年为43%（中位生存期为22.3个月）。多因素分析显示，每位患者肝转移灶体积的变异系数（CV）大于1.8是MCHM切除术后唯一的不良预后因素（P = 0.01，HR = 4.08，95% CI = 1.33 - 12.5）。
每位患者肝转移灶体积的CV大于1.8预示着MCHM肝切除术后生存率较低。因此，每位患者肝转移灶体积的CV可能有助于制定MCHM患者的治疗策略。
