Fujii Takaaki, Sutoh Toshinaga, Morita Hiroki, Katoh Toshihide, Yajima Reina, Araki Kenichiro, Sasaki Shigeru, Yamaguchi Satoru, Tsutsumi Soichi, Suzuki Hideki, Asao Takayuki, Kuwano Hiroyuki
Hepatogastroenterology. 2013 Sep;60(126):1348-50. doi: 10.5754/hge11648.
BACKGROUND/AIMS: The liver is the most common distant site of metastasis from colorectal cancer and is often the only organ affected. We hypothesized that whether distant disease is localized in the liver or is a more systemic disease, may be important in the prognosis of patients with synchronous liver metastasis. The purpose of this study was to investigate the possibility of localized liver metastasis in cases with colorectal synchronous liver metastasis and without lymph node involvement.
Three hundred and twenty-five consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 24 cases with synchronous liver metastasis were detected. Of these, 11 who underwent curative simultaneous surgical resection of primary tumor and liver metastases were analyzed in this study. The clinical and pathological features of these cases were reviewed.
Of the 11 patients with synchronous liver metastasis from colorectal cancer, 4 had disease recurrence, but none of those without regional node involvement had disease recurrence. In the multivariate analysis, only regional node metastases were significantly associated with disease recurrence. Recurrence-free interval by Kaplan-Meier curves differed significantly among patients with positive regional nodes.
Our results imply that synchronous liver metastasis without regional lymph node metastasis is localized disease.
背景/目的：肝脏是结直肠癌最常见的远处转移部位，且常常是唯一受累的器官。我们推测，远处疾病局限于肝脏还是一种更具全身性的疾病，可能对同时性肝转移患者的预后具有重要意义。本研究的目的是探讨在结直肠癌同时性肝转移且无淋巴结受累的病例中存在局限性肝转移的可能性。
确定325例接受结直肠切除术的连续患者纳入本研究，其中检测到24例同时性肝转移。其中，本研究分析了11例接受了原发性肿瘤和肝转移瘤同期根治性手术切除的患者。回顾了这些病例的临床和病理特征。
在11例结直肠癌同时性肝转移患者中，4例出现疾病复发，但在无区域淋巴结受累的患者中无一例出现疾病复发。在多变量分析中，只有区域淋巴结转移与疾病复发显著相关。根据Kaplan-Meier曲线，区域淋巴结阳性患者的无复发生存期差异显著。
我们的结果表明，无区域淋巴结转移的同时性肝转移是局限性疾病。
