Connor S, Hart M G, Redhead D N, Ireland H, Madhavan K K, Parks R W, Garden O J
Division of Clinical and Surgical Sciences (Surgery), University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom.
Eur J Surg Oncol. 2007 Feb;33(1):55-60. doi: 10.1016/j.ejso.2006.09.017. Epub 2006 Nov 13.
The aim of this study was to assess the value of a defined follow-up protocol for patients undergoing potentially curative hepatic resection for colorectal hepatic metastases.
A standard protocol for the duration of the study consisted of clinical assessment, serum carcinoembryonic antigen (CEA) and computed tomography. Patterns of recurrence, method and timing of diagnosis and outcome were recorded.
One hundred and ninety-one patients underwent potentially curative resection from 1989 to 2004 of whom 103 developed recurrence. The median (inter-quartile range) follow-up was 24.4 (6.5-42.3) months. The median (IQR) time to recurrence and overall survival was 25.0 (10 -not yet reached) and 45.2 (21-123) months, respectively. Seventeen patients (8.9%) underwent further surgery with curative intent. Fifty-five patients (57.9%) had recurrence diagnosed at routine follow-up with 71% (44/62) being diagnosed by CEA and CT. The CEA was elevated in 85.7% (72/84 patients) at the time of diagnosis of recurrence.
Although the detection of recurrent disease is common during follow-up after hepatic resection for colorectal metastases, few patients will be suitable for further intervention with curative intent. The exact nature of the follow-up protocol remains to be determined but if it is going to be performed it should be most intensive within the first 3 years.
本研究旨在评估为接受结直肠癌肝转移潜在根治性肝切除术的患者制定的随访方案的价值。
本研究的标准方案包括临床评估、血清癌胚抗原（CEA）和计算机断层扫描。记录复发模式、诊断方法和时间以及结果。
1989年至2004年期间，191例患者接受了潜在根治性切除术，其中103例出现复发。中位（四分位间距）随访时间为24.4（6.5 - 42.3）个月。复发的中位（IQR）时间和总生存期分别为25.0（10 - 未达到）个月和45.2（21 - 123）个月。17例患者（8.9%）接受了有治愈意图的进一步手术。55例患者（57.9%）在常规随访中被诊断为复发，其中71%（44/62）通过CEA和CT诊断。复发诊断时，85.7%（72/84例患者）的CEA升高。
尽管在结直肠癌肝转移肝切除术后的随访中，复发性疾病的检测很常见，但很少有患者适合进行有治愈意图的进一步干预。随访方案的确切性质仍有待确定，但如果要进行随访，应在头3年内最为密集。
