Gurusamy Kurinchi Selvan, Ramamoorthy Rajarajan, Imber Charles, Davidson Brian R
University Department of Surgery, Royal Free Hospital and University College School of Medicine, 9th Floor, Royal Free Hospital, Pond Street, London, UK, NW3 2QG.
Cochrane Database Syst Rev. 2010 Jan 20;2010(1):CD006797. doi: 10.1002/14651858.CD006797.pub2.
Involvement of hepatic lymph node in patients with colorectal liver metastases is associated with poor prognosis.
To determine the benefits and harms of curative liver resection with lymphadenectomy versus other treatments for colorectal liver metastases with hepatic node involvement.
We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and LILACS until September 2009 for identifying the randomised trials.
We considered only randomised clinical trials (irrespective of language, blinding, or publication status) comparing liver resection (alone or in combination with radiofrequency ablation or cryoablation) versus other treatments (neo-adjuvant chemotherapy, chemotherapy, or radiofrequency ablation) in patients with colorectal liver metastases with hepatic node involvement.
Two authors independently identified trials for inclusion.
We were unable to identify any randomised clinical trial fulfilling the inclusion criteria of this review. We were also unable to identify any quasi-randomised or cohort studies, which could meaningfully answer this important issue.
AUTHORS' CONCLUSIONS: There is no evidence in the literature to assess the role of surgery versus other treatments for patients with colorectal liver metastases with hepatic node involvement. High quality randomised clinical trials are feasible and are necessary to determine the optimal management of patients with colorectal liver metastases with hepatic node involvement.
结直肠癌肝转移患者出现肝门淋巴结受累与预后不良相关。
确定对于伴有肝门淋巴结受累的结直肠癌肝转移患者，行根治性肝切除加淋巴结清扫术与其他治疗方法相比的获益与危害。
我们检索了Cochrane肝胆组对照试验注册库、Cochrane图书馆中的Cochrane对照试验中央注册库（CENTRAL）、医学期刊数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）、科学引文索引扩展版以及拉丁美洲和加勒比卫生科学数据库（LILACS），检索截至2009年9月的随机试验。
我们仅纳入比较肝切除（单独或联合射频消融或冷冻消融）与其他治疗方法（新辅助化疗、化疗或射频消融）的随机临床试验（不考虑语言、盲法或发表状态），这些试验针对伴有肝门淋巴结受累的结直肠癌肝转移患者。
两位作者独立确定纳入试验。
我们未能找到任何符合本综述纳入标准的随机临床试验。我们也未能找到任何可有效回答这一重要问题的半随机或队列研究。
尚无文献证据可评估手术与其他治疗方法在伴有肝门淋巴结受累的结直肠癌肝转移患者中的作用。高质量的随机临床试验是可行的，对于确定伴有肝门淋巴结受累的结直肠癌肝转移患者的最佳治疗方案是必要的。
