Xu Jian-min, Qin Xin-yu, Zhong Yun-shi, Wei Ye, Fan Jia, Zhou Jian, Qin Lun-xiu, Wang Jian-hua, Yan Zhi-ping, Cheng Jie-min, Wu Zhao-han
Department of General Surgery, Zhongshan Hospital, China.
Zhonghua Zhong Liu Za Zhi. 2007 Jan;29(1):54-7.
To evaluate the correlation between different therapies and survival of liver metastasis from colorectal cancer ( LMCC) , and to compare the clinical outcome of synchronous liver metastasis (SLM) with that of metachronous liver metastasis (MLM).
The clinical data of 363 patients with LMCC were retrospectively reviewed with focus on the correlation between different therapy and survival.
Of these 363 patients, 160 had SLM and 203 had MLM. Between the SLM and MLM group, there was no significant difference in age, or gender or primary cancer site (P > 0. 05 ), but significant differences were observed in condition of liver metastasis including liver lobe involved, focus number, maximum focus diameters and level of serum CEA and CA199 before therapy(P <0. 05). Ninety-one patients underwent curative hepatic resection, 22 of them in the SLM group and 69 in the MLM group. Mortality rate related to operation was 4. 5% (1/22) in SLM group and 2. 9% (2/69) in MLM group( P < 0.05). All patients were followed until 31/6/2005. The 3-year survival rate was 5. 2% with a median survival time of 10 +/- 1 months for the SLM group, and it wasl6. 4% and 17 +/- 1 months for the MLM group (P<0.01). Regarding to the treatment modalities, the 3-year survival rate was 30. 2% with a median survival time of 26 months for curative hepatic resection group, and it was 0% - 16. 7% and 10 - 17 months for non-operation groups treated by intervention, chemotherapy, radiofrequency therapy, percutaneous ethanol injection and Chinese traditional drugs (P <0. 05, P <0. 01 ).
Curative hepatic resection is still the first choice for liver metastasis from colorectal cancer improving the survival significantly. Other non-operative methods also can improve phase II resection rate. Metachronous liver metastasis has higher resection rate and better survival than the synchronous liver one.
评估不同治疗方法与结直肠癌肝转移(LMCC)患者生存率之间的相关性,并比较同时性肝转移(SLM)与异时性肝转移(MLM)的临床结局。
回顾性分析363例LMCC患者的临床资料,重点关注不同治疗方法与生存率之间的相关性。
363例患者中,160例为SLM,203例为MLM。SLM组与MLM组在年龄、性别或原发癌部位方面无显著差异(P>0.05),但在肝转移情况方面存在显著差异,包括受累肝叶、病灶数量、最大病灶直径以及治疗前血清CEA和CA199水平(P<0.05)。91例患者接受了根治性肝切除术,其中SLM组22例,MLM组69例。SLM组手术相关死亡率为4.5%(1/22),MLM组为2.9%(2/69)(P<0.05)。所有患者随访至2005年6月31日。SLM组3年生存率为5.2%,中位生存时间为10±1个月;MLM组3年生存率为16.4%,中位生存时间为17±1个月(P<0.01)。就治疗方式而言,根治性肝切除组3年生存率为30.2%,中位生存时间为26个月;接受介入、化疗、射频治疗、经皮乙醇注射及中药治疗的非手术组3年生存率为0% - 16.7%,中位生存时间为10 - 17个月(P<0.05,P<0.01)。
根治性肝切除术仍是结直肠癌肝转移的首选治疗方法,可显著提高生存率。其他非手术方法也可提高二期切除率。异时性肝转移比同时性肝转移具有更高的切除率和更好的生存率。