肝转移瘤切除术后复发或转移性结直肠癌的新分类方案。

A new classification scheme for recurrent or metastatic colon cancer after liver metastasectomy.

机构信息

Division of Hematology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2011 Nov;74(11):493-9. doi: 10.1016/j.jcma.2011.09.004. Epub 2011 Nov 1.

DOI:10.1016/j.jcma.2011.09.004

PMID:22100018

Abstract

BACKGROUND

Metastasectomy is the standard treatment for patients with resectable liver metastasis from colon cancer. This study aimed to determine the impact of initial stage on overall survival (OS) after metastasectomy.

METHODS

A retrospective analysis of 2804 patients diagnosed with colon cancer between 1999 and 2008.

RESULTS

Of the cohort, 38.1% of the patients were stage IV or had recurrence after curative surgery, and 131 received liver metastasectomy. The 5-year survival rate for patients after liver metastasectomy was 42.1%. The 5-year survival rates after metastasectomy for initial stage I disease, stage II disease, stage III disease, and stage IV disease were 100%, 82.5%, 31.8%, and 36.9%, respectively (p = 0.014). When patients were grouped as initial stage I/II and stage III/IV, the 5-year survival rate after liver metastasectomy differed significantly (83.9% vs. 35.7%, p = 0.006). Patients with initial stage I/II disease after liver metastasectomy had a significantly better 5-year progression-free period compared to those with stage III/IV disease (60% vs. 28%, p = 0.021), which was due to the lower recurrence rate in the stage I/II group.

CONCLUSION

Our results suggest that patients who receive liver metastasectomy for metastatic colon cancer should be grouped into two groups: those with initial stages I and II disease, and those with stages III and IV disease, since the progression-free survivals (PFS) and OS after metastasectomy in these two groups differ significantly.

摘要

背景

肝转移切除术是治疗可切除结直肠癌肝转移患者的标准治疗方法。本研究旨在确定初始分期对肝转移切除术后总生存期（OS）的影响。

方法

回顾性分析 1999 年至 2008 年间诊断为结肠癌的 2804 例患者。

结果

队列中有 38.1%的患者为 IV 期或根治术后复发，131 例接受了肝转移切除术。肝转移切除术后患者的 5 年生存率为 42.1%。I 期、II 期、III 期和 IV 期疾病患者肝转移切除术后的 5 年生存率分别为 100%、82.5%、31.8%和 36.9%（p = 0.014）。当患者分为 I/II 期和 III/IV 期时，肝转移切除术后的 5 年生存率差异有统计学意义（83.9% vs. 35.7%，p = 0.006）。I/II 期疾病患者肝转移切除术后的 5 年无进展生存期明显长于 III/IV 期疾病患者（60% vs. 28%，p = 0.021），这是由于 I/II 期疾病患者的复发率较低。