[肝切除治疗结直肠癌肝转移的疗效]

[Therapeutic effects of hepatic resection in liver metastasis of colorectal cancer].

作者信息

Xu Jian-Min, Zhong Yun-Shi, Fan Jia, Zhou Jian, Qin Lun-Xiu, Niu Wei-Xin, Wei Ye, Ren Li, Lai Yan-Han, Zhu De-Xiang, Qin Xin-Yu, Wu Zhao-Han

机构信息

Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Apr 1;45(7):452-4.

PMID:17686299

Abstract

OBJECTIVES

To evaluate therapeutic effects of hepatic resection in liver metastasis of colorectal cancer (LMCC).

METHODS

The clinical data of 133 cases of LMCC received hepatic resection from January 1, 2000 to December 31, 2005 in Zhongshan Hospital were analyzed retrospectively. The relationship between hepatic resection and survival rate was also concerned.

RESULTS

One hundred and thirty-three cases received curative hepatic resection in all 470 LMCC cases, of which 30 cases from synchronous liver metastasis (SLM) group (totaled 196 cases) and 103 cases from metachronous liver metastasis (MLM) group (totaled 274 cases). Mortality rate during operation was 3.3% in SLM and 1.9% in MLM (P < 0.05). All patients were followed-up till June 31, 2006, the 1, 3, 5 year survival rates and median survival time of SLM were similar to those of MLM, but its recurrence rate was higher (36.7% vs 20.4%, P = 0.030). The 1, 3, 5 year survival rate in the 49 patients who were operable but received non-operation treatment were significantly lower than those in operated patients (P = 0.003). In 30 SLM cases, 22 received I stage resection of their primary and liver metastasis tumor and 8 received liver metastasis resection after the primary surgery (II stage operation), 1, 2, 3 year survival and the median survival time were similar in the two groups. With COX multivariate analysis, incision margin > or = 1 cm (P = 0.036) and reoperation after recurrence (P = 0.041) were protective survival factors, and post-operation recurrence (P = 0.023) was survival risk factor.

CONCLUSIONS

Curative hepatic resection is the first choice of therapy in liver metastasis of colorectal cancer and it can improve survival.

摘要

目的

评估肝切除治疗结直肠癌肝转移（LMCC）的疗效。

方法

回顾性分析2000年1月1日至2005年12月31日在中山医院接受肝切除的133例LMCC患者的临床资料。同时关注肝切除与生存率之间的关系。

结果

在470例LMCC患者中，133例接受了根治性肝切除，其中30例来自同时性肝转移（SLM）组（共196例），103例来自异时性肝转移（MLM）组（共274例）。SLM组手术死亡率为3.3%，MLM组为1.9%（P<0.05）。所有患者随访至2006年6月31日，SLM组的1、3、5年生存率及中位生存时间与MLM组相似，但其复发率更高（36.7%对20.4%，P=0.030）。49例可手术但未接受手术治疗的患者的1、3、5年生存率显著低于接受手术治疗的患者（P=0.003）。在30例SLM患者中，22例接受了原发肿瘤和肝转移瘤的I期切除，8例在原发手术后接受了肝转移瘤切除（II期手术），两组的1、2、3年生存率及中位生存时间相似。经COX多因素分析，切缘≥1 cm（P=0.036）和复发后再次手术（P=0.041）是生存保护因素，术后复发（P=0.023）是生存危险因素。