Eto Tada-Aki, Chijiiwa Kazuo, Hidaka Hideki, Ohuchida Jiro, Kai Masa-Hiro, Kondo Kazuhiro, Hotokezaka Masayuki
Department of Surgery I, Miyazaki University School of Medicine, Miyazaki, Japan.
Hepatogastroenterology. 2006 Nov-Dec;53(72):909-12.
BACKGROUND/AIMS: Although the size and number of the metastatic liver tumors have been considered to be prognostic factors after hepatectomy in patients with colorectal liver metastases, the importance of these parameters is still controversial. The aim of this study was to evaluate the importance of the new factor, namely, the sum of longest diameters of the metastatic liver tumors (SLD).
The medical records of 59 patients who had undergone hepatic resection for colorectal liver metastases were abstracted and these patients were completely followed-up.
The overall 5-year survival rate after hepatectomy was 38.5%, and median survival time was 25.9 months. The significant prognostic factors by the univariate analysis were the extents of vessel permeation and lymph node metastasis of primary colorectal carcinoma, the presence of extrahepatic metastasis, the longest diameter and SLD of the liver tumor, surgical margin of the liver, and the serum level of carcinoembryonic antigen. Multivariate analysis showed that SLD (P=0.026) and extrahepatic distant organ metastasis (P=0.008) were the independent prognostic factor.
SLD is a useful and significant predictor for survival after hepatectomy in patients with colorectal liver metastases.
背景/目的：尽管在结直肠癌肝转移患者肝切除术后，转移灶的大小和数量一直被视为预后因素，但这些参数的重要性仍存在争议。本研究旨在评估新因素——转移灶最长径总和（SLD）的重要性。
提取59例行肝切除治疗结直肠癌肝转移患者的病历，并对这些患者进行完整随访。
肝切除术后5年总生存率为38.5%，中位生存时间为25.9个月。单因素分析显示，显著的预后因素包括原发性结直肠癌的血管浸润程度和淋巴结转移情况、肝外转移的存在、肝肿瘤的最长径和SLD、肝脏手术切缘以及癌胚抗原血清水平。多因素分析表明，SLD（P = 0.026）和肝外远处器官转移（P = 0.008）是独立的预后因素。
SLD是结直肠癌肝转移患者肝切除术后生存的一个有用且重要预测指标。
