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肝切除术治疗非结直肠、非神经内分泌、非肉瘤转移瘤:单中心经验。

Hepatic resection for non-colorectal, non-neuroendocrine, non-sarcoma metastasis: a single-centre experience.

机构信息

Department of Hepatobiliary and Transplantation Surgery, Queen Elizabeth Hospital, University Hospital of Birmingham NHS Foundation Trust, Birmingham, UK.

出版信息

HPB (Oxford). 2011 Apr;13(4):286-92. doi: 10.1111/j.1477-2574.2010.00285.x. Epub 2011 Mar 2.

Abstract

BACKGROUND

The aim of the present study was to analyse the outcome after hepatic resection for non-colorectal, non-neuroendocrine, non-sarcomatous (NCNNNS) metastatic tumours and to identify the factors predicting survival.

METHODS

All patients who underwent hepatic resection for NCNNNS metastatic tumours between September 1996 and June 2009 were included. Patients' demographics, clinical and histopathological parameters, overall survival and the factors predicting survival were analysed.

RESULTS

In all, 65 patients underwent hepatic resection for metastasis. The most common site of a primary tumour was the kidney (24 patients). Fifteen patients had synchronous tumours. Fifty patients had major liver resections and 22 patients had bilobar disease. The median number of liver lesions resected was 1 and the median maximum diameter of the metastasis was 6 cm. A R0 resection was performed in 51 patients. The 1-, 3- and 5-year overall survival from the time of metastasectomy was 72.9%, 47.9% and 25.6%, respectively, with a median survival of 19 months. The presence of a tumour of greater than 6 cm (P= 0.048) and a positive resection margin (P= 0.04) were associated with poor survival.

CONCLUSION

Hepatic resection for metastasis from NCNNNS tumours can offer acceptable long-term survival in selected patients. To offer a chance of a cure a R0 resection must be performed.

摘要

背景

本研究旨在分析非结直肠、非神经内分泌、非肉瘤(NCNNNS)转移性肿瘤肝切除术后的结果,并确定预测生存的因素。

方法

纳入 1996 年 9 月至 2009 年 6 月期间因 NCNNNS 转移性肿瘤接受肝切除术的所有患者。分析患者的人口统计学、临床和组织病理学参数、总生存率和预测生存率的因素。

结果

共有 65 例患者因转移接受了肝切除术。原发肿瘤最常见的部位是肾脏(24 例)。15 例患者为同步肿瘤。50 例患者接受了大肝切除术,22 例患者有双侧肝病变。切除的肝转移灶中位数为 1 个,转移灶的最大直径中位数为 6cm。51 例患者获得了 R0 切除。从转移切除术时起,1、3 和 5 年的总生存率分别为 72.9%、47.9%和 25.6%,中位生存时间为 19 个月。肿瘤大于 6cm(P=0.048)和阳性切缘(P=0.04)与不良预后相关。

结论

对 NCNNNS 肿瘤转移行肝切除术可使部分患者获得可接受的长期生存。为了获得治愈的机会,必须进行 R0 切除。

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