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妇科癌症肝转移的手术治疗——适应证与结果

Surgery of liver metastasis in gynecological cancer - indication and results.

作者信息

Kollmar Otto, Moussavian Mohammed R, Richter Sven, Bolli Martin, Schilling Martin K

机构信息

Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.

出版信息

Onkologie. 2008 Jul;31(7):375-9. doi: 10.1159/000135516. Epub 2008 Jun 23.

Abstract

BACKGROUND

Liver surgery for patients with liver metastases from gynecological malignancies, an indicator of advanced cancer disease, has remained unclear in the literature. We therefore analyzed the potential survival benefit of patients with surgically resectable compared to unresectable liver metastases.

PATIENTS AND METHODS

43 patients who underwent surgery for liver metastases from gynecological cancers were included in our retrospective observational analysis. Overall survival was estimated according to the Kaplan-Meier method and compared with the log-rank test.

RESULTS

Primary gynecological tumors were breast (n = 27), ovarian (n = 8), and uterine (n = 8) cancers. Solely exploratory laparotomy was performed in 13 patients who served as controls. Whereas the perioperative mortality was 0%, minor complications occurred in 18.7%. The overall survival of all patients undergoing liver resection was significantly higher (p < 0.05) than that of patients with unresectable metastases. Subgroup analyses showed that particularly patients with respectable liver metastases from breast cancer had a significantly higher (50%) 5-year survival compared to patients with only an exploratory laparotomy.

CONCLUSION

In selected patients, liver resection of metastases from gynecological cancers can achieve a survival benefit similar to that of patients with colorectal cancer metastases.

摘要

背景

对于患有妇科恶性肿瘤肝转移的患者进行肝脏手术,这一晚期癌症疾病的指标在文献中仍不明确。因此,我们分析了可手术切除与不可切除肝转移患者的潜在生存获益。

患者与方法

43例行妇科癌症肝转移手术的患者纳入我们的回顾性观察分析。根据Kaplan-Meier方法估计总生存期,并与对数秩检验进行比较。

结果

原发性妇科肿瘤为乳腺癌(n = 27)、卵巢癌(n = 8)和子宫癌(n = 8)。13例患者仅行 exploratory laparotomy 作为对照。围手术期死亡率为0%,轻微并发症发生率为18.7%。所有接受肝切除患者的总生存期显著高于不可切除转移患者(p < 0.05)。亚组分析显示,与仅行 exploratory laparotomy 的患者相比,尤其是来自乳腺癌的可切除肝转移患者5年生存率显著更高(50%)。

结论

在选定的患者中,妇科癌症转移灶的肝切除可实现与结直肠癌转移患者相似的生存获益。

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