Department of Surgery, Clinical Sciences Lund, Skåne University Hospital Lund, Lund University, Lund 22185, Sweden.
World J Surg. 2012 Jan;36(1):157-63. doi: 10.1007/s00268-011-1342-x.
Liver resection is a possibly curative treatment for colorectal cancer (CRC) liver metastases. Preoperative chemotherapy may make initially irresectable tumors resectable. The aim of this study was to compare perioperative course and short-term mortality after liver resection for CRC metastases between patients who were and were not treated with preoperative chemotherapy.
Patients who had undergone liver resection for CRC metastases were included. A total of 97 patients treated with preoperative chemotherapy (group A) were compared with 136 who were not (group B). Intraoperative bleeding, operating time, complications, duration of stay, and mortality were compared using Pearson's χ(2) test, Fisher's exact test, and the Mann-Whitney U-test.
Mean intraoperative bleeding, duration of stay, and operating time were not significantly different. Complications occurred in 62.9% and 63.2% in groups A and B, respectively. The 30- and 90-day mortality rates were zero in group A, comparable to 1.5% in group B.
There were no significant differences in the perioperative course or postoperative mortality when comparing CRC patients with or without chemotherapy prior to liver resection. Consequently, this study suggests that preoperative chemotherapy before liver resection for CRC metastases does not negatively influence perioperative outcome and can therefore be applied if "downstaging" is indicated.
肝切除术是结直肠癌（CRC）肝转移的一种可能的治愈性治疗方法。术前化疗可能使最初不可切除的肿瘤变为可切除。本研究的目的是比较接受和不接受术前化疗的 CRC 肝转移患者行肝切除术后的围手术期过程和短期死亡率。
纳入接受 CRC 肝转移肝切除术的患者。共有 97 例接受术前化疗的患者（A 组）与 136 例未接受化疗的患者（B 组）进行比较。使用 Pearson χ(2)检验、Fisher 确切检验和 Mann-Whitney U 检验比较术中出血量、手术时间、并发症、住院时间和死亡率。
术中出血量、住院时间和手术时间无显著差异。A 组和 B 组的并发症发生率分别为 62.9%和 63.2%。A 组的 30 天和 90 天死亡率均为 0%，与 B 组的 1.5%相当。
在接受或不接受化疗的 CRC 患者中，肝切除术前的围手术期过程或术后死亡率无显著差异。因此，如果存在“降期”情况，建议在 CRC 肝转移患者行肝切除术前应用术前化疗，这并不会对围手术期结果产生负面影响。
