Preketes A P, Caplehorn J R, King J, Clingan P R, Ross W B, Morris D L
Department of Surgery, University of New South Wales, St. George Hospital, Kogarah, Sydney, Australia.
World J Surg. 1995 Sep-Oct;19(5):768-71. doi: 10.1007/BF00295928.
Thirty-eight patients with unresectable multiple liver metastases from colorectal carcinoma were treated with either hepatic artery chemotherapy (HAC) and cryotherapy (n = 27) or cryotherapy alone (n = 11). Follow-up survival data were summarized using Cox regression. Allowing for the effect of the pathology of the primary tumor and the preoperative carcinoembryonic antigen (CEA) level, those patients who did not receive HAC after cytoreduction were three times as likely to die as those given HAC (RR 3.3, 95%; CI 1.2-9.3). The estimated median survival of patients treated with cryotherapy alone was 245 days, whereas for those given more than 3 months of HAC plus cytoreduction therapy it was 570 days. It is recommended that all patients who receive cryotherapy for multiple liver metastases from colorectal rectal carcinoma be given subsequent hepatic artery chemotherapy.
38例无法切除的结直肠癌多发性肝转移患者接受了肝动脉化疗（HAC）联合冷冻治疗（n = 27）或单纯冷冻治疗（n = 11）。采用Cox回归总结随访生存数据。考虑到原发肿瘤的病理情况和术前癌胚抗原（CEA）水平的影响，减瘤后未接受HAC的患者死亡可能性是接受HAC患者的3倍（风险比3.3，95%；置信区间1.2 - 9.3）。单纯接受冷冻治疗患者的估计中位生存期为245天，而接受3个月以上HAC加量减瘤治疗的患者为570天。建议所有因结直肠癌多发性肝转移接受冷冻治疗的患者随后接受肝动脉化疗。
