Fegiz G, Bezzi M, De Angelis R, Provitera B, Ramacciato G, Maceratini R, Tucci G, Angelini L
Ital J Surg Sci. 1985;15(3):259-65.
The experience with 28 patients undergoing hepatic resection for metastases from colorectal cancer is reported. In 15 cases the metastases were synchronous, in 13 metachronous, appearing 12 to 60 months after surgery of primary cancer. Six patients underwent right lobectomy, 2 left lobectomy, 9 left lateral segmentectomy, 6 right wedge resection and 2 bilateral wedge resection. In 20 cases the lesions were solitary, in 8 multiple. Overall operative mortality was 14.2%. Mean survival for synchronous metastases was 16 months with 3 patients living beyond 12 months, and 26 months for metachronous metastases with 4 patients living beyond 12 months. The obtained results are analyzed on the basis of staging of primary cancer, of the metastatic disease and type of resection, examining the morbidity and cause of long term mortality. It is evidenced that, even if correct pre- and intraoperative staging of metastatic disease is impossible, an aggressive surgical approach is the treatment of choice in surgically resectable liver metastases from colorectal cancer.
报告了28例因结直肠癌肝转移接受肝切除手术患者的经验。15例为同时性转移,13例为异时性转移,在原发性癌症手术后12至60个月出现。6例患者接受了右叶切除术,2例接受了左叶切除术,9例接受了左外侧段切除术,6例接受了右楔形切除术,2例接受了双侧楔形切除术。20例患者的病变为单发,8例为多发。总体手术死亡率为14.2%。同时性转移患者的平均生存期为16个月,3例患者存活超过12个月;异时性转移患者的平均生存期为26个月,4例患者存活超过12个月。根据原发性癌症的分期、转移性疾病的分期和切除类型对所得结果进行分析,检查发病率和长期死亡率的原因。结果表明,即使无法对转移性疾病进行正确的术前和术中分期,积极的手术方法仍是结直肠癌肝转移可手术切除时的首选治疗方法。