Amano Ryosuke, Yamada Nobuya, Nakata Bunzo, Kimura Kenjiro, Yashiro Masakazu, Ohira Masaichi, Hirakawa Kosei
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan,
Surg Today. 2014 Jul;44(7):1287-92. doi: 10.1007/s00595-013-0699-x. Epub 2013 Aug 27.
We investigated the predictive indicator for a good prognosis of surgical resection for liver metastasis of colorectal cancer.
Between 1990 and 2009 at our institute, 117 patients underwent 132 hepatic resections for liver metastasis of colorectal cancer. The clinical, pathological, and outcome parameters affecting their prognoses were analyzed. The extent of the liver metastases was subdivided according to the Japanese Classification of Colorectal Carcinoma (JCCRC), and the patients were classified into different grades based on the JCCRC classification and the status of the nodal involvement of the primary tumor.
The median survival time (MST) of the 117 patients was 58 months, and the actuarial survival rates at 1, 3, and 5 years were 92.3, 60.0, and 46.1 %, respectively. A multivariate analysis revealed that the JCCRC Grade classification was an independent prognostic indicator (Grade A vs. B vs. C: MST, 72 vs. 41 vs. 23 months; 5-year survival, 59.0 vs. 38.6 vs. 0 %: p < 0.0001).
Our findings indicate that the JCCRC Grade classification for liver metastasis of colorectal cancer is a significant prognostic indicator and may be useful for making decisions regarding the treatment of liver metastasis.
我们研究了结直肠癌肝转移手术切除预后良好的预测指标。
1990年至2009年期间，我院117例患者因结直肠癌肝转移接受了132次肝切除术。分析了影响其预后的临床、病理和结局参数。根据日本结直肠癌分类（JCCRC）对肝转移范围进行细分，并根据JCCRC分类和原发肿瘤的淋巴结受累情况将患者分为不同等级。
117例患者的中位生存时间（MST）为58个月，1年、3年和5年的精算生存率分别为92.3%、60.0%和46.1%。多因素分析显示，JCCRC分级分类是一个独立的预后指标（A级与B级与C级：MST，72个月对41个月对23个月；5年生存率，59.0%对38.6%对0%：p<0.0001）。
我们的研究结果表明，结直肠癌肝转移的JCCRC分级分类是一个重要的预后指标，可能有助于做出关于肝转移治疗的决策。
