Shin Heeji, Kim Chan Wook, Lee Jong Lyul, Yoon Yong Sik, Park In Ja, Lim Seok-Byung, Yu Chang Sik, Kim Jin Cheon
Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.
ANZ J Surg. 2019 Jan;89(1-2):61-67. doi: 10.1111/ans.14933. Epub 2018 Nov 28.
The aim of this study was to identify the prognostic factors affecting recurrence and survival in patients who underwent curative intent surgery for colorectal cancer (CRC) with a single liver metastasis.
Between January 2006 and August 2012, we retrospectively evaluated 141 patients for CRC with single liver metastasis underwent curative intent surgery for colon and liver simultaneously. Some patients (11.3%) had radiofrequency ablation as an option.
The 5-year disease-free and overall survival (OS) rates were 38.9% and 59.6%, respectively. Recurrence occurred in 77 (54.6%) patients after surgery. Multivariate analysis identified node positivity and no adjuvant chemotherapy as independent risk factors for OS. We analyzed the OS risk factors in 76 recurred patients from the time of recurrence. Multivariate analysis revealed the following significant risk factors for OS after recurrence: a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis.
Patients who underwent a curative resection for CRC with a single liver metastasis had a relatively favourable prognosis; in these patients, node positivity and no adjuvant chemotherapy were independent prognostic factors for OS. Furthermore, a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis may be independent prognostic factors for OS in patients with recurrence. The left hepatic metastasis group tended to have a multiple hepatic relapse more frequently than the right hepatic metastasis group in cases of isolated hepatic relapse.
本研究旨在确定影响接受根治性手术治疗的单发肝转移结直肠癌（CRC）患者复发和生存的预后因素。
2006年1月至2012年8月期间，我们回顾性评估了141例同时接受结肠和肝脏根治性手术治疗的单发肝转移CRC患者。部分患者（11.3%）选择了射频消融治疗。
5年无病生存率和总生存率（OS）分别为38.9%和59.6%。术后77例（54.6%）患者出现复发。多因素分析确定淋巴结阳性和未接受辅助化疗是OS的独立危险因素。我们从复发时起分析了76例复发患者的OS危险因素。多因素分析显示复发后OS的以下显著危险因素：复发时血清癌胚抗原浓度高、复发后的治疗类型（化疗或未治疗）和左肝转移。
接受根治性切除的单发肝转移CRC患者预后相对较好；在这些患者中，淋巴结阳性和未接受辅助化疗是OS的独立预后因素。此外，复发时血清癌胚抗原浓度高、复发后的治疗类型（化疗或未治疗）和左肝转移可能是复发患者OS的独立预后因素。在孤立性肝复发的情况下，左肝转移组比右肝转移组更易发生多发性肝复发。
