Zhai Shengyong, Sun Xiaojing, Du Longfeng, Chen Kai, Zhang Shanshan, Shi Yiran, Yuan Fei
Department of Oncology Surgery, Weifang People' s Hospital, Weifang Medical College, Weifang City, Shandong Province, 261041, People's Republic of China.
School of Management and Information, Shandong Transport Vocational College, Weifang City, Shandong Province, 261041, People's Republic of China.
Cancer Manag Res. 2021 May 7;13:3699-3711. doi: 10.2147/CMAR.S300890. eCollection 2021.
This study is a retrospective analysis of exploring the efficiency of surgical management on patients with synchronous colorectal liver metastasis (SCLM).
Nine hundred fifty-three consecutive patients with SCLM from Weifang People's Hospital of Shandong Province between January 2006 and December 2015 were reviewed. The values of different factors were analyzed, such as different surgical indications of liver metastases, simultaneous or staged resection of primary colorectal cancer and liver metastases, and primary tumor resection (PTR) of asymptomatic patients with unresectable liver metastases.
Median survival time (47.3 months) and 5-year survival rate (31%) for patients with resected liver metastases were significantly superior to that of with nonoperative treatment (17.2 months, 4%, P<0.001); enlarging the standard of liver metastases resection can improve the resection rates (31.0% vs 13.6%, P<0.001); for patients with resectable liver metastases, the in-hospital cost for simultaneous resection group was lower than that in the staged resection group (36,698 vs 45,134 RMB, P<0.001); for patients of the asymptomatic primary tumor with unresectable liver metastases, PTR was associated with improved median survival (18.0 vs 15.0 months, P=0.006).
For patients with SCLM, liver resection is considered the best treatment; expanding indications of liver resection can improve the resection rates. Simultaneous resection of the primary tumor and liver metastases were indicated in patients with resectable SCLM; PTR was recommended for asymptomatic patients with unresectable hepatic metastases.
本研究是一项回顾性分析，旨在探讨手术治疗同步性结直肠癌肝转移（SCLM）患者的疗效。
回顾性分析2006年1月至2015年12月期间山东省潍坊市人民医院连续收治的953例SCLM患者。分析了不同因素的价值，如肝转移的不同手术指征、原发性结直肠癌和肝转移的同期或分期切除，以及不可切除肝转移无症状患者的原发性肿瘤切除（PTR）。
肝转移切除患者的中位生存时间（47.3个月）和5年生存率（31%）显著优于非手术治疗患者（17.2个月，4%，P<0.001）；扩大肝转移切除标准可提高切除率（31.0%对13.6%，P<0.001）；对于可切除肝转移患者，同期切除组的住院费用低于分期切除组（36,698元对45,134元，P<0.001）；对于不可切除肝转移的无症状原发性肿瘤患者，PTR与中位生存改善相关（18.0对15.0个月，P=0.006）。
对于SCLM患者，肝切除被认为是最佳治疗方法；扩大肝切除指征可提高切除率。可切除SCLM患者建议同期切除原发性肿瘤和肝转移；对于不可切除肝转移的无症状患者，建议行PTR。
