Spelt Lidewij, Sasor Agata, Ansari Daniel, Andersson Roland
a Department of Surgery , Clinical Sciences Lund, Lund University and Skåne University Hospital , Lund , Sweden ;
b Department of Pathology , Skåne University Hospital , Lund , Sweden.
Scand J Gastroenterol. 2016 Oct;51(10):1233-8. doi: 10.1080/00365521.2016.1190400. Epub 2016 Jun 16.
To identify significant predictive factors for overall survival (OS) and disease-free survival (DFS) after liver resection for colon cancer metastases, with special focus on features of the primary colon cancer, such as lymph node ratio (LNR), vascular invasion, and perineural invasion.
Patients operated for colonic cancer liver metastases between 2006 and 2014 were included. Details on patient characteristics, the primary colon cancer operation and metastatic disease were collected. Multivariate analysis was performed to select predictive variables for OS and DFS.
Median OS and DFS were 67 and 20 months, respectively. 1-, 3- and 5-year OS were 97, 76, and 52%. 1-, 3- and 5-year DFS were 65, 42, and 37%. Multivariate analysis showed LNR to be an independent predictive factor for DFS but not for OS. Other identified predictive factors were vascular and perineural invasion of the primary colon cancer, size of the largest metastasis and severe complications after liver surgery for OS, and perineural invasion, number of liver metastases and preoperative CEA-level for DFS. Traditional N-stage was also considered to be an independent predictive factor for DFS in a separate multivariate analysis.
LNR and perineural invasion of the primary colon cancer can be used as a prognostic variable for DFS after a concomitant liver resection for colon cancer metastases. Vascular and perineural invasion of the primary colon cancer are predictive for OS.
确定结肠癌肝转移灶切除术后总生存期（OS）和无病生存期（DFS）的显著预测因素，特别关注原发性结肠癌的特征，如淋巴结比率（LNR）、血管侵犯和神经周围侵犯。
纳入2006年至2014年间接受结肠癌肝转移手术的患者。收集患者特征、原发性结肠癌手术及转移性疾病的详细信息。进行多因素分析以选择OS和DFS的预测变量。
OS和DFS的中位数分别为67个月和20个月。1年、3年和5年的OS分别为97%、76%和52%。1年、3年和5年的DFS分别为65%、42%和37%。多因素分析显示LNR是DFS的独立预测因素，但不是OS的独立预测因素。其他确定的预测因素包括原发性结肠癌的血管和神经周围侵犯、最大转移灶的大小以及肝切除术后的严重并发症与OS相关，神经周围侵犯、肝转移灶数量和术前癌胚抗原（CEA）水平与DFS相关。在单独的多因素分析中，传统的N分期也被认为是DFS的独立预测因素。
原发性结肠癌的LNR和神经周围侵犯可作为结肠癌肝转移灶切除术后DFS的预后变量。原发性结肠癌的血管和神经周围侵犯对OS有预测作用。
