Sauter E R, Bolton J S, Willis G W, Farr G H, Sardi A
Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
J Surg Oncol. 1990 Mar;43(3):135-8. doi: 10.1002/jso.2930430303.
While hepatic resection of metastatic colorectal carcinoma is accepted as effective in selected patients, resection of metastases to other solid organs has not gained wide acceptance. We retrospectively reviewed the records of 49 patients who had resection of isolated pulmonary (18 patients) and hepatic (31 patients) metastases from the large bowel, comparing disease-free survival and overall survival. Tumor parameters analyzed included Dukes' stage, deoxyribonucleic acid (DNA) flow cytometry, and number of metastases. Dukes' B and diploid tumors had longer disease-free survival and overall survival than did Dukes' C and aneuploid tumors, though the difference was not significant. Patients with a single lung metastasis had a significantly longer disease-free survival (P = .02) than did patients with multiple metastases. Mean and median survival were longer in patients with lung metastases. Five-year actuarial survival was 19% for patients with liver metastases and 47% for patients with lung metastases. Resection of isolated pulmonary metastases from the large intestine results in survival comparable to or better than resection of hepatic metastases. An aggressive surgical approach is warranted in patients with isolated resectable pulmonary metastases of colorectal carcinoma.
虽然转移性结直肠癌的肝切除在特定患者中被认为是有效的，但向其他实体器官的转移灶切除尚未得到广泛认可。我们回顾性分析了49例大肠孤立性肺转移（18例）和肝转移（31例）患者的手术记录，比较无病生存期和总生存期。分析的肿瘤参数包括Dukes分期、脱氧核糖核酸（DNA）流式细胞术和转移灶数量。Dukes B期和二倍体肿瘤的无病生存期和总生存期比Dukes C期和非整倍体肿瘤长，尽管差异不显著。单发性肺转移患者的无病生存期显著长于多发性转移患者（P = 0.02）。肺转移患者的平均生存期和中位生存期更长。肝转移患者的5年精算生存率为19%，肺转移患者为47%。大肠孤立性肺转移灶切除后的生存率与肝转移灶切除相当或更好。对于可切除的大肠孤立性肺转移患者，积极的手术方法是必要的。
