Taylor I, Rowling J, West C
Br J Surg. 1979 Dec;66(12):833-7. doi: 10.1002/bjs.1800661202.
Colorectal liver metastases develop by malignant cells entering the portal venous circulation. A randomized prospective clinical trial was commenced in 1975 to assess the value of adjuvant umbilical vein cytotoxic perfusion (with 5-fluorouracil) following colorectal resection. One hundred and fifty-four patients without macroscopic liver secondaries have so far entered the trial. The mean age, sex, site and stage of the disease were similar in the control and perfusion groups and there was no statistically significant difference in postoperative complications or hospital stay (17.1 +/- 7.9 days control, 15.8 +/- 7.4 days perfusion group). So far, 23 deaths have occurred in the control group (20 due to recurrent disease) and 7 in the perfusion group (5 due to recurrent disease). Liver metastases were present in 13 control patients and 2 perfusion patients. These results show an encouraging trend and suggest that adjuvant cytotoxic liver perfusion may reduce the development of colorectal liver metastases and hence improve the subsequent prognosis.
结直肠肝转移是由恶性细胞进入门静脉循环所致。1975年开展了一项随机前瞻性临床试验，以评估结直肠切除术后辅助性脐静脉细胞毒性灌注（使用5-氟尿嘧啶）的价值。迄今为止，154例无肉眼可见肝转移的患者进入了该试验。对照组和灌注组患者的疾病平均年龄、性别、部位和分期相似，术后并发症或住院时间（对照组17.1±7.9天，灌注组15.8±7.4天）无统计学显著差异。迄今为止，对照组有23例死亡（20例死于复发性疾病），灌注组有7例死亡（5例死于复发性疾病）。13例对照组患者和2例灌注组患者出现了肝转移。这些结果显示出令人鼓舞的趋势，表明辅助性细胞毒性肝灌注可能减少结直肠肝转移的发生，从而改善后续预后。
