Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Asia Pac J Clin Oncol. 2022 Apr;18(2):e182-e185. doi: 10.1111/ajco.13547. Epub 2021 Apr 18.
The prognosis of patients with multiple liver metastasis of colorectal cancer (CLM) on both lobes accompanied by a portal vein tumor thrombus (PVTT) remains unclear. We report two patients with multiple CLM and PVTT who underwent liver resection. A 73-year-old man had successful extended right hemi-hepatectomy with a thrombectomy for a macroscopic tumor thrombus in the right portal branch and multiple CLM in both lobes. At 8 months after surgery, the patient had multiple CLM in the remnant lobe with left main PVTT and died 14 months after liver surgery. A 64-year-old woman who had previously undergone palliative chemotherapy for adenocarcinoma of the ascending colon presented with CLM accompanied by a macroscopic tumor thrombus in the left portal branch. Tumor and PVTT had progressed despite various regimens of chemotherapy. Left hemi-hepatectomy with radiofrequency ablation on right lobe and right hemicolectomy were performed. However, CLM occurred again within 3 months after the liver surgery. Considering these cases, a poor prognosis may be expected even though the tumor is successfully removed by liver resection.
对于同时伴有门静脉癌栓（PVTT）的双侧叶多发结直肠癌肝转移（CLM）患者的预后仍不清楚。我们报告了 2 例接受肝切除术的多发 CLM 和 PVTT 患者。1 例 73 岁男性成功地进行了右半肝扩大切除术，包括右门静脉分支的宏观肿瘤血栓和双侧叶的多个 CLM。术后 8 个月，患者在残肝内出现多个 CLM，同时伴有左主 PVTT，并在肝手术后 14 个月死亡。另 1 例 64 岁女性曾因升结肠癌行姑息性化疗，出现伴有左门静脉分支大的肿瘤血栓的 CLM。尽管进行了各种化疗方案，肿瘤和 PVTT 仍在进展。行左半肝切除术联合右叶射频消融术和右半结肠切除术。然而，肝手术后 3 个月内再次出现 CLM。考虑到这些病例，即使通过肝切除术成功切除肿瘤，预后也可能较差。
