结直肠肝转移瘤的原发灶位置和临床危险因素与手术治疗的长期结果。
Long-term Results of Surgery for Colorectal Liver Metastases in Terms of Primary Tumour Location and Clinical Risk Factors.
机构信息
Department of Surgery, University Hospital, School of Medicine in Pilsen, Pilsen, Czech Republic
Department of Surgery, University Hospital, School of Medicine in Pilsen, Pilsen, Czech Republic.
出版信息
In Vivo. 2020 Sep-Oct;34(5):2675-2685. doi: 10.21873/invivo.12087.
BACKGROUND/AIM: The aim of the study was to evaluate the influence of primary tumour location and clinical risk factors for long-term results of surgery for colorectal liver metastases (CLMs).
PATIENTS AND METHODS
Overall survival (OS) and recurrence-free survival (RFS) were evaluated in 636 patients. Patients were divided by tumour location (right-/left-sided colorectal cancer: RCRC/LCRC; rectal cancer), and age, gender, number and size of CLMs, type of liver surgery and interval from primary operation were evaluated.
RESULTS
One-, 3- and 5-year OS and RFS were independent of primary tumour location (p<0.59). CLM diameter was negatively associated with OS for the whole cohort (p<0.002), and RCRC (p<0.03) and LCRC (p<0.04) groups, as well as for RFS of those with LCRC (p<0.04). CLM number was negatively associated with RFS for the whole cohort (p<0.0001), RCRC (p<0.02), LCRC (p<0.0001) and RC (p<0.02). Radiofrequency ablation and combined procedures led to worse OS for the whole cohort (p<0.03), and to worse RFS for the whole cohort (p<0.0003) and for those with LCRC (p<0.03). A shorter interval between primary colorectal cancer surgery and CLMs procedure was risky for poor OS and RFS of patients with CLMs from RCRC (p<0.05), LCRC (p<0.05) and RC (p<0.02).
CONCLUSION
Primary tumour location together with clinical risk factors are important for long-term results of surgery CLMs.
背景/目的：本研究旨在评估原发肿瘤位置和临床危险因素对结直肠癌肝转移（CLM）手术长期结果的影响。
患者和方法
对 636 例患者的总生存期（OS）和无复发生存期（RFS）进行了评估。患者按肿瘤位置（右/左结直肠癌：RCRC/LCRC；直肠癌）、年龄、性别、CLM 的数量和大小、肝切除术类型以及从原发手术的间隔进行了分组，并对这些因素进行了评估。
结果
在整个队列中，1 年、3 年和 5 年的 OS 和 RFS 与原发肿瘤位置无关（p<0.59）。CLM 直径与整个队列的 OS 呈负相关（p<0.002），与 RCRC（p<0.03）和 LCRC（p<0.04）组以及 LCRC 患者的 RFS 呈负相关（p<0.04）。CLM 数量与整个队列的 RFS 呈负相关（p<0.0001），与 RCRC（p<0.02）、LCRC（p<0.0001）和 RC（p<0.02）组均呈负相关。射频消融和联合手术导致整个队列的 OS 较差（p<0.03），以及整个队列（p<0.0003）和 LCRC 患者（p<0.03）的 RFS 较差。原发结直肠癌手术后与 CLMs 手术之间的间隔较短与 RCRC（p<0.05）、LCRC（p<0.05）和 RC（p<0.02）患者的 OS 和 RFS 不良有关。
结论
原发肿瘤位置与临床危险因素是 CLM 手术长期结果的重要因素。
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