Yamaguchi Tatsuro, Mori Takeo, Takahashi Keiichi, Matsumoto Hiroshi, Miyamoto Hidenori, Kato Tomoyuki
Department of Surgery, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
Hepatogastroenterology. 2008 Jan-Feb;55(81):173-8.
BACKGROUND/AIMS: Although numerous authors have reported various prognostic factors for liver metastases from colorectal cancer, there is not yet a general classification.
A total of 478 colorectal cancer patients from 18 institutes were studied. Prognostic factors were investigated using univariate and multivariate analyses.
Independent prognostic factors for colorectal liver metastases were number of liver metastases, size of the largest liver metastases, mesenteric lymph node metastases (pN0/1: < or =3 lesions, pN2: > or =4 lesions), and extrahepatic metastases (EM0: absence of extrahepatic metastasis, EM1: presence of extrahepatic metastases). We defined the following classification system; Stage A: HT1 (< or =4 lesions and < or =5cm) and pN0/1, Stage B: HT2 (> or =5 lesions or >5cm) and pN0/1, or HT1 and pN2, Stage C: HT2 and pN2, HT3 (> or =5 lesions and >5cm) with any pN, or any HT and any pN with EM1. Five-year survival rates were 53.5% for Stage A patients, 25.4% for Stage B patients, and 5.8% for Stage C patients. Median survival time was 70.4 months, 31.4 months, and 17.2 months, respectively.
Our classification was advocated to evaluate prognoses for liver metastases from colorectal cancer. It can help guide decision making in terms of liver resection and assessing patient prognosis.
背景/目的：尽管众多作者报道了结直肠癌肝转移的各种预后因素，但尚未有通用的分类方法。
对来自18家机构的478例结直肠癌患者进行研究。采用单因素和多因素分析研究预后因素。
结直肠癌肝转移的独立预后因素为肝转移灶数量、最大肝转移灶大小、肠系膜淋巴结转移（pN0/1：≤3个病灶，pN2：≥4个病灶）和肝外转移（EM0：无肝外转移，EM1：有肝外转移）。我们定义了以下分类系统；A期：HT1（≤4个病灶且≤5cm）且pN0/1，B期：HT2（≥5个病灶或＞5cm）且pN0/1，或HT1且pN2，C期：HT2且pN2，HT3（≥5个病灶且＞5cm）伴任何pN，或任何HT伴任何pN且有EM1。A期患者的5年生存率为53.5%，B期患者为25.4%，C期患者为5.8%。中位生存时间分别为70.4个月、31.4个月和17.2个月。
我们倡导的这种分类方法用于评估结直肠癌肝转移的预后。它有助于指导肝切除决策和评估患者预后。
