Hotta Tsukasa, Takifuji Katsunari, Uchiyama Kazuhisa, Yokoyama Shozo, Matsuda Kenji, Higashiguchi Takashi, Tominaga Toshiji, Oku Yoshimasa, Nasu Toru, Yamaue Hiroki
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Oncol Rep. 2006 Dec;16(6):1369-74. doi: 10.3892/or.16.6.1369.
Liver resection has been recognized as the best treatment for patients with colorectal liver metastases, but as a curative resection for multiple and bilobar colorectal liver metastases (MBCLM) it is definitely less effective. We clarify predictors of survival for unresectable MBCLM. Potential predictors of overall survival, and the correlation between tumor marker and survival were evaluated for patients with synchronous unresectable MBCLM, including 6 rectal and 17 colon cancers. In univariate analysis, survival in patients with the following parameters were longer than those without them: number of liver metastases (</=10), without lung metastasis and peritoneal invasion, and with a <1.0 ratio of postoperative CEA/preoperative CEA. In multivariate analysis, the numbers of liver metastases (>10) and a >1.0 ratio of postoperative CEA/preoperative CEA were factors of poor prognosis, and patients with two such factors had an even worse prognosis. There was a tendency for correlation between the ratio of postoperative CEA/pre-operative CEA and survival (R=-0.492, P=0.053; y=17.388-3.733x). Thus, we clarified some of the predictors of survival for MBCLM, and the usefulness of serum CEA.
肝切除术已被公认为是结直肠癌肝转移患者的最佳治疗方法,但作为多发性和双侧性结直肠癌肝转移(MBCLM)的根治性切除术,其疗效肯定较差。我们明确了不可切除的MBCLM患者的生存预测因素。对包括6例直肠癌和17例结肠癌在内的同步不可切除的MBCLM患者评估了总生存的潜在预测因素以及肿瘤标志物与生存之间的相关性。在单因素分析中,具有以下参数的患者的生存期长于无这些参数的患者:肝转移灶数量(≤10个)、无肺转移和腹膜侵犯、术后CEA/术前CEA比值<1.0。在多因素分析中,肝转移灶数量(>10个)和术后CEA/术前CEA比值>1.0是预后不良的因素,具有这两个因素的患者预后更差。术后CEA/术前CEA比值与生存之间存在一定的相关性趋势(R=-0.492,P=0.053;y=17.388-3.733x)。因此,我们明确了MBCLM患者的一些生存预测因素以及血清CEA的实用性。