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结直肠肝转移患者与非结直肠肝转移患者手术结局的比较:中国经验。

Comparison of surgical outcomes in patients with colorectal liver metastases versus non-colorectal liver metastases: A Chinese experience.

机构信息

Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

出版信息

Hepatol Res. 2012 Mar;42(3):296-303. doi: 10.1111/j.1872-034X.2011.00917.x. Epub 2011 Dec 5.

Abstract

AIM

To compare the surgical treatment outcomes between patients with colorectal liver metastases (CLM) and non-colorectal liver metastases (NCLM).

METHODS

The study population consisted of 132 patients undergoing hepatectomy at Tianjin Medical University Cancer Hospital between January 1996 and December 2008. Survival analyses were used to assess the differences in prognosis and survival between groups.

RESULTS

The primary tumor site was colorectal in 60 (45.5%), breast in 16 (12.1%), lung in 14 (10.6%), non-colorectal gastrointestinal in 12 (9.1%), genitourinary in 10 (7.6%), pancreatobiliary tumor (n = 8, 6.1%) and others in 12 (9.1%). A curative liver resection was performed in all patients by pathological findings. After a median follow-up of 32 months, the overall 3- and 5-year survival rate was 44.7 and 29.5% in all patients, respectively. The 3- and 5-year survival rates were 53.3 and 36.7% for liver metastases from colorectal tumors, 62.5 and 43.8% from breast, 60.0 and 40.0% from genitourinary neoplasm, 41.7 and 25.0% from non-colorectal gastrointestinal cancer, 28.5 and 15.0% from lung, 12.5 and 0% from pancreatobiliary malignancies, and 41.7 and 8.3% from other sites, respectively.

CONCLUSIONS

Hepatic resection is an effective and safe treatment for liver metastases mainly depending on primary tumor sites. Hepatic metastases from non-colorectal gastrointestinal cancer, pulmonary and pancreatobiliary malignancies have the worst prognosis; those from breast and genitourinary neoplasm show the best prognosis.

摘要

目的

比较结直肠肝转移(CLM)和非结直肠肝转移(NCLM)患者的手术治疗效果。

方法

该研究纳入了 1996 年 1 月至 2008 年 12 月在天津医科大学肿瘤医院接受肝切除术的 132 例患者。采用生存分析评估组间预后和生存差异。

结果

原发肿瘤部位为结直肠 60 例(45.5%),乳腺 16 例(12.1%),肺 14 例(10.6%),非结直肠胃肠道 12 例(9.1%),泌尿生殖系统 10 例(7.6%),胰腺胆道肿瘤 8 例(6.1%)和其他 12 例(9.1%)。所有患者均经病理检查行根治性肝切除术。中位随访 32 个月后,所有患者的总 3 年和 5 年生存率分别为 44.7%和 29.5%。结直肠肿瘤肝转移患者的 3 年和 5 年生存率分别为 53.3%和 36.7%,乳腺肿瘤为 62.5%和 43.8%,泌尿生殖系统肿瘤为 60.0%和 40.0%,非结直肠胃肠道癌为 41.7%和 25.0%,肺癌为 28.5%和 15.0%,胰腺胆道恶性肿瘤为 12.5%和 0%,其他部位为 41.7%和 8.3%。

结论

肝切除术是一种有效且安全的治疗方法,主要取决于原发肿瘤部位。非结直肠胃肠道癌、肺癌和胰腺胆道恶性肿瘤肝转移患者预后最差,乳腺和泌尿生殖系统肿瘤肝转移患者预后最好。

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