Palkovics András, Vereczkei András, Kalmár Károly Nagy, Fincsur András, Kiss Isván, Németh Balázs, Papp András
Department of Surgery, Medical School University of Pécs, Pécs, Hungary
Department of Surgery, Medical School University of Pécs, Pécs, Hungary.
Anticancer Res. 2018 Nov;38(11):6431-6438. doi: 10.21873/anticanres.13004.
BACKGROUND/AIM: Nowadays, obtaining optimal surgical margin of the resected metastasis and the parenchyma- sparing surgical technique are a great challenge for hepatic surgeons. The aim of this follow-up study was to investigate the prognostic value of the surgical margin and the parenchyma- sparing liver resection technique.
We performed a retrospective analysis of the data of 319 patients [123 (36.6%) female and 196 (61.4%) male] who had colorectal cancer and underwent surgery to treat colorectal liver metastases in our Department between 2005 and 2014.
The most commonly used resection type was the non-anatomic resection (43%). Multivariate analysis indicated that there was no significant difference in survival (p=0.473) between the microscopically-negative (R0) and microscopically-positive (R1) resections, as well as between the resection types (p=0.257).
Parenchymal-sparing non-anatomic resection and spray diathermy on the resection surface of the liver should be applied not only for hemostasis, but also to destroy the area containing possible tumor cells after an R1 resection and not to have worse survival outcomes.
背景/目的:如今,获得切除转移灶的最佳手术切缘以及保留肝实质的手术技术对肝脏外科医生而言是巨大挑战。这项随访研究的目的是探讨手术切缘和保留肝实质肝切除技术的预后价值。
我们对2005年至2014年间在我科接受手术治疗结直肠癌肝转移的319例患者[123例(36.6%)女性和196例(61.4%)男性]的数据进行了回顾性分析。
最常用的切除类型是非解剖性切除(43%)。多因素分析表明,显微镜下阴性(R0)切除与显微镜下阳性(R1)切除之间以及不同切除类型之间在生存率方面无显著差异(p = 0.473和p = 0.257)。
保留肝实质的非解剖性切除以及在肝脏切除表面进行喷雾热凝不仅应用于止血,还应用于在R1切除后破坏可能含有肿瘤细胞的区域,且不会导致更差的生存结果。