Jiang Ling-Min, Zhang Yuan-Ping, Wang Chen-Wei, Zhang Wei-Dong, He Wei, Qiu Ji-Liang, Yuan Yi-Chuan, Li Bin-Kui, Yuan Yun-Fei, Lai Ren-Chun, Hu Dan-Dan, Zheng Yun
Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China and Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
J Oncol. 2022 Apr 21;2022:3819564. doi: 10.1155/2022/3819564. eCollection 2022.
Whether more tumor numbers detected in surgery compared to preoperative image affecting survival of colorectal liver metastases (CRLM) patients after hepatectomy combined with microwave ablation (MWA) remains unclear.
From 2013 to 2018, 85 CRLM patients who underwent hepatectomy combined with MWA were retrospectively assessed. Compared to the tumor numbers in preoperative image, patients with equal intraoperative tumor numbers were defined as the equal number group ( = 45); patients detected more tumor numbers in surgery were defined as the more number group ( = 40). Clinicopathological factors and prognosis were compared between two groups.
Compared to the equal number group, the more number group was characterized by more lymphatic metastasis, synchronous metastasis of liver lesion, and tumor numbers over 5 (all < 0.05). Median survival time was 46.7 months and 26.8 months in the equal and more number group. Significantly worse overall survival (OS) was found in more number group to the equal number group ( = 0.027). In Cox analysis, more tumor number than image and high level of carbohydrate antigen 19-9 (CA19-9) were poor prognostic factors for OS.
In patients receiving hepatectomy combined with MWA, detecting more liver metastases in surgery than preoperative image indicates poor long-term survival. These patients were characterized by more lymphatic metastasis, synchronous metastasis of liver lesion, and tumor numbers over 5. Intensive follow-up to detect early recurrence and potent postoperative therapy to improve survival may be justified in patients detected more tumor numbers in surgery with a high CA19-9 level.
与术前影像检查相比，手术中检测到更多的肿瘤数量是否会影响肝切除联合微波消融（MWA）术后结直肠癌肝转移（CRLM）患者的生存情况尚不清楚。
回顾性评估2013年至2018年期间接受肝切除联合MWA的85例CRLM患者。与术前影像检查中的肿瘤数量相比，术中肿瘤数量相同的患者被定义为等量组（n = 45）；手术中检测到更多肿瘤数量的患者被定义为多量组（n = 40）。比较两组的临床病理因素和预后情况。
与等量组相比，多量组的特征为更多的淋巴转移、肝病灶的同时性转移以及肿瘤数量超过5个（均P < 0.05）。等量组和多量组的中位生存时间分别为46.7个月和26.8个月。多量组的总生存期（OS）明显差于等量组（P = 0.027）。在Cox分析中，手术中比影像检查发现更多的肿瘤数量以及高水平的糖类抗原19-9（CA19-9）是OS的不良预后因素。
在接受肝切除联合MWA的患者中，手术中检测到的肝转移灶比术前影像检查更多表明长期生存较差。这些患者的特征为更多的淋巴转移、肝病灶的同时性转移以及肿瘤数量超过5个。对于手术中检测到更多肿瘤数量且CA19-9水平高的患者，进行强化随访以检测早期复发并采取有效的术后治疗以提高生存率可能是合理的。
