Zhang Ye-Fan, Mao Rui, Chen Xiao, Zhao Jian-Jun, Bi Xin-Yu, Li Zhi-Yu, Zhou Jian-Guo, Zhao Hong, Huang Zhen, Sun Yong-Kun, Cai Jian-Qiang
Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Chin Med J (Engl). 2017 Jun 5;130(11):1283-1289. doi: 10.4103/0366-6999.206349.
The liver is the most common site for colorectal cancer (CRC) metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases (CRCLM) who underwent simultaneous resections for both lesions.
From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival (OS) and disease-free survival (DFS) were examined by Kaplan-Meier and log-rank methods.
Median follow-up time was 22.7 months; no perioperative death or serious complications were observed. Median OS was 55.5 months; postoperative OS rates were 1-year: 93.8%, 3-year: 60.7%, and 5-year: 46.4%. Median DFS was 9.0 months; postoperative DFS rates were 1-year: 43.1%, 3-year: 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen ≥100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age ≥60 years, no adjuvant chemotherapy, multiple metastases, and largest diameter ≥3 cm for DFS.
Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRCLM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.
肝脏是结直肠癌（CRC）转移最常见的部位。切除肝脏转移灶是CRC治疗的关键且具有挑战性的方面。我们研究了同时切除两种病灶的CRC合并肝转移（CRCLM）患者的预后及危险因素。
2009年1月至2016年8月，102例CRCLM患者在我院接受了CRCLM的同时切除。我们回顾性分析了他们的临床资料并分析了其结局。采用Kaplan-Meier法和对数秩检验分析总生存期（OS）和无病生存期（DFS）。
中位随访时间为22.7个月；未观察到围手术期死亡或严重并发症。中位OS为55.5个月；术后1年、3年和5年的OS率分别为93.8%、60.7%和46.4%。中位DFS为9.0个月；术后1年、3年和5年的DFS率分别为43.1%、23.0%和21.1%。多因素分析中发现的独立危险因素，对于OS包括癌胚抗原≥100 ng/ml、未进行辅助化疗、肝转移灶有肿瘤血栓以及双叶肝转移；对于DFS包括年龄≥60岁、未进行辅助化疗、多发转移以及最大直径≥3 cm。
同时手术切除对同步性CRCLM患者是一种安全有效的治疗方法。主要预后因素是肝转移灶的病理特征以及是否进行标准辅助化疗。
