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同步双叶与非同步单叶肝切除术治疗结直肠癌肝转移的回顾性分析:肿瘤学结局和患者生存。

Liver Resection in Synchronous Bilobar versus Unilobar Colorectal Liver Metastases: A Retrospective Analysis of Oncological Outcomes and Patient Survival.

机构信息

Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Surgery, Munich, Germany,

Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Surgery, Munich, Germany.

出版信息

Dig Surg. 2024;41(3):103-110. doi: 10.1159/000538359. Epub 2024 May 3.

Abstract

INTRODUCTION

Resection of colorectal liver metastasis has emerged as the standard treatment. Our study compares oncological outcomes of patients with resected synchronous bilobar versus unilobar colorectal liver metastasis.

METHODS

This retrospective study presents long-term follow-up data of 105 consecutive patients with primary colorectal cancer and synchronous liver metastasis. All patients underwent primary tumor and metastasis resections between 2007 and 2019.

RESULTS

Fifty-five patients with bilobar and 50 patients with unilobar colorectal liver metastases were included. No significant difference in overall, tumor-specific, or recurrence-free survival was observed between patients with bilobar and unilobar metastases. After case-control matching, the results were confirmed in patients with similar tumor burdens. In the multivariate analysis, chemotherapy following liver metastasis resection was a significant prognostic factor associated with improved overall survival (hazard ratio 0.518, 95% confidence interval: 0.302-0.888, p = 0.017).

CONCLUSION

Overall survival, as well as tumor-specific and recurrence-free survival, did not differ between patients with unilobar and bilobar liver metastasis. These findings contribute to the understanding that primary tumor and metastasis resection in eligible patients improve long-term outcomes.

摘要

简介

结直肠肝转移的切除术已成为标准治疗方法。我们的研究比较了切除同步双侧与单侧结直肠肝转移的患者的肿瘤学结果。

方法

这项回顾性研究提供了 105 例原发性结直肠癌和同步肝转移患者的长期随访数据。所有患者均在 2007 年至 2019 年间接受了原发肿瘤和转移灶切除术。

结果

55 例患者存在双侧肝转移,50 例患者存在单侧肝转移。双侧和单侧肝转移患者的总体生存率、肿瘤特异性生存率和无复发生存率均无显著差异。在病例对照匹配后,在肿瘤负荷相似的患者中证实了这一结果。多变量分析显示,肝转移切除术后化疗是与总体生存率提高相关的显著预后因素(风险比 0.518,95%置信区间:0.302-0.888,p = 0.017)。

结论

单侧和双侧肝转移患者的总体生存率、肿瘤特异性生存率和无复发生存率无差异。这些发现有助于理解在合适的患者中进行原发肿瘤和转移灶切除术可改善长期预后。

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