同期与分期切除治疗可切除结直肠癌肝转移的疗效及预后比较
Comparison of the effects and prognosis of concurrent and staged resections for the treatment of resectable colorectal cancer liver metastasis.
作者信息
Fei Faming, Zhou Zhongcheng, Shen Yiyu, Su Zhiwei
机构信息
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Jiaxing University Jiaxing, Zhejiang Province, China.
Department of General Surgery, Jiaxing Maternity and Child Health Care Hospital Jiaxing, Zhejiang Province, China.
出版信息
Am J Transl Res. 2021 Apr 15;13(4):3634-3641. eCollection 2021.
OBJECTIVE
To compare the effects and prognosis of concurrent and staged resections for the treatment of resectable colorectal cancer liver metastasis (CRLM).
METHODS
A prospective study was conducted on 118 patients with CRLM. The 59 cases in the observation group received concurrent resections, while the 59 cases in the control group received staged resections. The operation time, intraoperative blood loss, length of hospital stay, hospital cost, postoperative complications, 5-year survival rate and 3-year progression-free survival rate were recorded for all patients. Factors that affect the prognosis of CRLM patients were analyzed.
RESULTS
The length of hospital stay, operation time, intraoperative blood loss, hospital cost were significantly lower in the observation group than in the control group (P<0.001). The two groups were equivalent with respect to postoperative complications, 5-year survival rate and 3-year progression-free survival rate (P>0.05). Independent risk factors affecting the prognosis of CRLM included the number of liver metastasis, whether resection is feasible after recurrence, and RAS genotype (P<0.05).
CONCLUSION
Compared to staged resection for CRLM, concurrent resection has shorter operation time, less blood loss, and shorter length of hospital stay, while postoperative complications, long-term efficacy and survival benefits are comparable. Furthermore, the study has found that the number of liver metastasis, whether or not resection is feasible after recurrence, and RAS genotype are risk factors affecting the prognosis of CRLM.
目的
比较同期切除与分期切除治疗可切除的结直肠癌肝转移（CRLM）的效果及预后。
方法
对118例CRLM患者进行前瞻性研究。观察组59例接受同期切除，对照组59例接受分期切除。记录所有患者的手术时间、术中出血量、住院时间、住院费用、术后并发症、5年生存率和3年无进展生存率。分析影响CRLM患者预后的因素。
结果
观察组的住院时间、手术时间、术中出血量、住院费用均显著低于对照组（P<0.001）。两组在术后并发症、5年生存率和3年无进展生存率方面相当（P>0.05）。影响CRLM预后的独立危险因素包括肝转移灶数量、复发后是否可行再次切除以及RAS基因分型（P<0.05）。
结论
与CRLM分期切除相比，同期切除手术时间更短、出血量更少、住院时间更短，而术后并发症、长期疗效和生存获益相当。此外，研究发现肝转移灶数量、复发后是否可行再次切除以及RAS基因分型是影响CRLM预后的危险因素。
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