Yan Tristan D, Chu Francis, Black Deborah, King Denis W, Morris David L
Department of Surgery, University of New South Wales, St. George Hospital, Sydney, NSW 2217, Australia.
World J Surg. 2007 Jul;31(7):1496-501. doi: 10.1007/s00268-007-9085-4. Epub 2007 May 30.
Patients with synchronous colorectal liver metastases are thought to have a less favorable prognosis than those with colorectal cancer alone. Surgical treatment options are controversial, be it synchronous resection or staged resection. This study compared the clinical, perioperative, disease-free survival (DFS), and overall survival (OS) results of patients undergoing synchronous resection versus staged resection.
An observational cohort study of 103 patients with synchronous colorectal liver metastases was performed. All data were collected prospectively. Clinical, perioperative, DFS, and OS results of patients undergoing synchronous resection (group I, n = 73) and staged resection (group II, n = 30) were compared.
More patients in group I had poorly differentiated colorectal cancer, bilobar liver metastases, more than three liver metastases, < or =4 cm liver metastases, and shorter hospital stays than patients in group II. There were no significant statistically differences in DFS and OS between the two groups. The median DFS of groups I and II were 28 and 26 months, respectively (p = 0.585). The median OS of groups I and II were 37 and 36 months, respectively (p = 0.900).
Synchronous resection achieved DFSs and OSs similar to those seen after staged resection while avoiding a second major operation.
同时性结直肠癌肝转移患者被认为比单纯结直肠癌患者的预后更差。手术治疗方案存在争议，无论是同期切除还是分期切除。本研究比较了同期切除与分期切除患者的临床、围手术期、无病生存期（DFS）和总生存期（OS）结果。
对103例同时性结直肠癌肝转移患者进行了一项观察性队列研究。所有数据均前瞻性收集。比较了同期切除患者（I组，n = 73）和分期切除患者（II组，n = 30）的临床、围手术期、DFS和OS结果。
与II组患者相比，I组中更多患者患有低分化结直肠癌、双叶肝转移、超过三处肝转移、肝转移灶直径≤4 cm，且住院时间更短。两组之间的DFS和OS无显著统计学差异。I组和II组的中位DFS分别为28个月和26个月（p = 0.585）。I组和II组的中位OS分别为37个月和36个月（p = 0.900）。
同期切除在避免二次大手术的同时，获得了与分期切除相似的DFS和OS。
