Department of Orthopedics, Medical University of Graz, Auenbruggerplatz 6, 8036 Graz, Austria.
Langenbecks Arch Surg. 2011 Oct;396(7):1083-91. doi: 10.1007/s00423-011-0821-8. Epub 2011 Jul 8.
Liver metastases originating from various types of sarcoma are a rare reason for hepatic resection. So far, even multicentre studies do hardly provide statistically relevant sample sizes. Thus, review of available data can provide surgeons with useful information in similar cases. Therefore, this study can be regarded more as a contribution to this pool of data than as a stand-alone paper.
The study includes 10 women and five men who underwent subtotal hepatic resection for solitary (n = 4) and multiple (n = 11) liver metastases originating from sarcoma. The median tumour diameter was 60 mm (range 20-200 mm).
Morbidity was 33%. One patient died within 30 days after surgery. Resection was complete (R0) in 67%. Median overall survival was 33.6 months, 5-year survival 27%. The use of Pringle manoeuvre was significantly associated with poorer outcome (p = 0.014) and shorter period of recurrence-free survival (p = 0.012). Diameter of liver lesion over 50 mm showed significantly shorter recurrence-free survival (p = 0.042).
Hepatic resection may be beneficial in patients with isolated sarcoma metastasis in the liver.
源自各种类型肉瘤的肝转移是肝切除术的一个罕见原因。到目前为止,即使是多中心研究也几乎无法提供具有统计学意义的样本量。因此,对现有数据的回顾可以为外科医生在类似病例中提供有用的信息。因此,这项研究与其说是一篇独立的论文,不如说是对这组数据的一个贡献。
该研究纳入了 10 名女性和 5 名男性患者,他们因肉瘤单发(n=4)或多发(n=11)肝转移接受了次全肝切除术。肿瘤的中位直径为 60mm(范围 20-200mm)。
发病率为 33%。1 例患者术后 30 天内死亡。67%的患者达到了完全切除(R0)。中位总生存期为 33.6 个月,5 年生存率为 27%。使用 Pringle 手法与较差的结果显著相关(p=0.014),无复发生存期也较短(p=0.012)。肝脏病变直径大于 50mm 与无复发生存期明显缩短相关(p=0.042)。
对于孤立性肝转移肉瘤患者,肝切除术可能是有益的。