Kortz W J, Meyers W C, Hanks J B, Schirmer B D, Jones R S
Ann Surg. 1984 Feb;199(2):182-6. doi: 10.1097/00000658-198402000-00009.
One-year survival is infrequent in patients with metastatic cancer to the liver. This report includes 21 patients who underwent hepatic resection between 1974 and 1981. Operative procedures included one trisegmentectomy, 12 right hepatic lobectomies, two left hepatic lobectomies, two left lateral segmentectomies, and four wedge resections. Operative morbidity and mortality rates were 43% and 5%, respectively. Life-table analysis revealed an overall 7-year survival rate of 34%. The subset of patients (16) with colorectal adenocarcinoma had a 7-year survival rate of 29% after hepatic resection. In three patients with colorectal adenocarcinoma, frequent CEA determinations were made after surgery in order to calculate the serum half-life of CEA. The data fitted a biexponential function yielding two half-lives for CEA disappearance, 0.8 +/- 0.5 days and 25.9 +/- 10.3 days. We conclude that hepatic resection for isolated hepatic metastases can be performed with acceptable morbidity, low mortality, and prolongation of patient survival.
发生肝转移的癌症患者的1年生存率很低。本报告纳入了1974年至1981年间接受肝切除的21例患者。手术方式包括1例三段切除术、12例右肝叶切除术、2例左肝叶切除术、2例左外侧段切除术和4例楔形切除术。手术并发症发生率和死亡率分别为43%和5%。寿命表分析显示总体7年生存率为34%。结直肠腺癌患者亚组(16例)肝切除术后7年生存率为29%。在3例结直肠腺癌患者中,术后频繁测定癌胚抗原(CEA)以计算CEA的血清半衰期。数据拟合双指数函数,得出CEA消失的两个半衰期,分别为0.8±0.5天和25.9±10.3天。我们得出结论,对于孤立性肝转移灶进行肝切除,其并发症发生率可接受,死亡率低,且能延长患者生存期。