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肝切除在转移性泌尿系统恶性肿瘤治疗中的角色演变

Evolving Role of Hepatic Resection for Metastatic Urologic Malignancies.

作者信息

Hamner John B, Raoof Mustafa, Dumitra Sinziana, Schoellhammer Hans F, Crowder Carly, Ituarte Philip H G, Kim Joseph, Singh Gagandeep

出版信息

Am Surg. 2017 Jun 1;83(6):628-632.

Abstract

Liver resection for noncolorectal, nonneuroendocrine metastases remains controversial. Here, we evaluate a single institutional experience with hepatic resection for metastatic urologic malignancies. A single-institution review of patients who underwent hepatic resection for metastatic urologic tumors between the years of 2000 and 2013 was performed. Patient charts were analyzed for pathologic data and perioperative outcomes including short- and long-term morbidity, mortality, and overall and disease-free survival. Eleven patients were identified who underwent hepatic resection for metastatic urologic malignancy. The mean age was 63.5 years. All patients had an R0 resection. There were three major complications. Mean length of stay was 6.5 days and there was no 90-day mortality. Three patients have died of recurrent disease at an average of 11.2 months from resection to death. The remaining patients are still alive during a mean follow-up of 31.5 months. Five-year overall and disease-free survival was 50 and 21 months, respectively. Hepatic resection for metastatic urologic tumors is safe with low morbidity and mortality and durable long-term survival can be achieved. Liver resection for isolated hepatic disease should be considered for this rare metastatic disease to the liver.

摘要

对于非结直肠癌、非神经内分泌转移瘤的肝切除术仍存在争议。在此,我们评估了一家机构对转移性泌尿系统恶性肿瘤进行肝切除术的经验。对2000年至2013年间因转移性泌尿系统肿瘤接受肝切除术的患者进行了单机构回顾。分析患者病历的病理数据以及围手术期结果,包括短期和长期发病率、死亡率以及总生存期和无病生存期。确定了11例因转移性泌尿系统恶性肿瘤接受肝切除术的患者。平均年龄为63.5岁。所有患者均行R0切除。发生了3例严重并发症。平均住院时间为6.5天,90天内无死亡病例。3例患者死于复发性疾病,从切除到死亡的平均时间为11.2个月。其余患者在平均31.5个月的随访期间仍存活。5年总生存期和无病生存期分别为50个月和21个月。对转移性泌尿系统肿瘤进行肝切除术是安全的,发病率和死亡率低,可实现持久的长期生存。对于这种罕见的肝脏转移疾病,应考虑对孤立性肝脏病变进行肝切除术。

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