Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
J Gastrointest Surg. 2011 Oct;15(10):1798-806. doi: 10.1007/s11605-011-1642-3. Epub 2011 Jul 23.
More and more complications of extensive hepatic resection are being encountered in patients treated for liver metastases from colorectal cancer. This study aimed to determine the impact of liver abscess after hepatic resection on overall survival (OS) and the role of adjuvant chemotherapy.
This is a retrospective study of 252 patients treated by liver metastasectomy between 2001 and 2010.
The 5-year survival rate was 55.8%. Twenty-one (8.3%) patients developed liver abscess after liver metastasectomy. Multivariate analysis identified the size of liver metastasis, surgical margin, and the presence of liver abscess as significant prognostic factors. Patients (whether or not they developed liver abscess after hepatic resection) had similar progression-free survival (median, 9.8 vs. 12.4 months, P = 0.476), but patients who developed liver abscess had significantly shorter OS (26.6 vs. 76.0 months, P = 0.004). Subsequent adjuvant therapy significantly improved OS in these patients (16.9 vs. 38.5 months, P = 0.032).
Liver abscess after liver metastasectomy is an independent prognostic factor, and adjuvant chemotherapy is warranted in those patients who develop liver abscess.
在接受结直肠癌肝转移治疗的患者中,广泛肝切除术后的并发症越来越多。本研究旨在确定肝切除术后肝脓肿对总生存期(OS)的影响,以及辅助化疗的作用。
这是一项对 2001 年至 2010 年间接受肝转移切除术治疗的 252 例患者进行的回顾性研究。
5 年生存率为 55.8%。21 例(8.3%)患者在肝转移切除术后发生肝脓肿。多因素分析确定肝转移灶的大小、手术切缘和肝脓肿的存在是显著的预后因素。是否发生肝脓肿的患者具有相似的无进展生存期(中位数分别为 9.8 个月和 12.4 个月,P=0.476),但发生肝脓肿的患者 OS 明显缩短(26.6 个月和 76.0 个月,P=0.004)。随后的辅助治疗显著改善了这些患者的 OS(16.9 个月和 38.5 个月,P=0.032)。
肝转移切除术后肝脓肿是一个独立的预后因素,对于发生肝脓肿的患者,辅助化疗是必要的。