Tuttle T M, Curley S A, Roh M S
Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Ann Surg Oncol. 1997 Mar;4(2):125-30. doi: 10.1007/BF02303794.
Approximately 20-40% of patients who undergo liver resection for colorectal metastases develop recurrent disease confined to the liver. The goals of this study were to determine whether the survival benefit of repeat hepatic resection justified the potential morbidity and mortality.
A retrospective review was performed on all patients who underwent liver resection for colorectal cancer metastases between 1983 and 1995 (N = 202). Repeat liver resections were performed on 23 patients for recurrent metastases.
There were no operative deaths in the 23 patients, and the postoperative morbidity rate was 22%. The 5-year actuarial survival rate after repeat resection was 32%, with a median length of survival of 39.9 months. There were three patients who survived for > 5 years after repeat resection. Sixteen patients (70%) developed recurrent disease at a median interval of 11 months after the second resection; 10 of these 16 patients (62%) had new hepatic metastases. No clinical or pathological factors were significant in predicting long-term survival.
Repeat liver resection for recurrent colorectal metastases (a) can be performed safely with acceptable mortality and morbidity rates and (b) may result in long-term survival in some patients.
接受肝切除治疗结直肠癌肝转移的患者中，约20% - 40%会出现局限于肝脏的复发性疾病。本研究的目的是确定再次肝切除带来的生存获益是否能抵消其潜在的发病率和死亡率。
对1983年至1995年间接受肝切除治疗结直肠癌转移的所有患者（N = 202）进行回顾性分析。23例患者因复发性转移接受了再次肝切除。
23例患者中无手术死亡，术后发病率为22%。再次切除后的5年精算生存率为32%，中位生存期为39.9个月。有3例患者在再次切除后存活超过5年。16例患者（70%）在第二次切除后中位间隔11个月出现复发性疾病；这16例患者中有10例（62%）出现新的肝转移。没有临床或病理因素能显著预测长期生存。
对复发性结直肠癌肝转移进行再次肝切除（a）可以安全进行，死亡率和发病率可接受，（b）可能使部分患者获得长期生存。
