Kim G E, Lee S W, Suh C O, Park T K, Kim J W, Park J T, Shim J U
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University, College of Medicine, Seoul, Korea.
Gynecol Oncol. 1998 Jul;70(1):56-60. doi: 10.1006/gyno.1998.5037.
To investigate the patterns of hepatic involvement and the outcome of patients with hepatic metastases from carcinoma of the uterine cervix.
Of 1665 patients with carcinoma of the uterine cervix, 20 patients with hepatic metastases were detected clinically during the course of the disease. Clinical presentation and detailed patterns of hepatic involvement were retrospectively reviewed for these patients. Comparative analysis between patterns of heaptic metastases and survival data was also undertaken.
Hepatic metastasis from carcinoma of the uterine cervix were nearly always accompanied by uncontrolled locoregional diseases and/or extrahepatic metastases, whereas only 1 patient developed an isolated hepatic metastasis. Ninety percent of the hepatic metastases were metachronously detected. The median time from the appearance of primary carcinoma to detection of hepatic metastases was 39 months, but late metastases after 5 years were not uncommon. Metastatic lesion in 16 patients consisted of multiple tumors distributed in either one or both anatomical lobes, whereas only 4 patients had a solitary lesion confined to a single lobe. Patients with hepatic metastases were unlikely to survive 2 years with a median survival of 10 months.
Favorable patterns of hepatic metastases in patient with carcinoma of the uterine cervix were not major determinants of favorable survival if components of extrahepatic disease were concomitantly present.
探讨子宫颈癌肝转移患者的肝脏受累模式及预后。
在1665例子宫颈癌患者中,有20例在疾病过程中临床检测到肝转移。对这些患者的临床表现及肝脏受累的详细模式进行回顾性分析。同时对肝转移模式与生存数据进行比较分析。
子宫颈癌肝转移几乎总是伴有局部区域疾病控制不佳和/或肝外转移,仅有1例发生孤立性肝转移。90%的肝转移为异时性发现。从原发性癌出现到检测到肝转移的中位时间为39个月,但5年后出现晚期转移并不少见。16例患者的转移灶为多个肿瘤,分布于一个或两个肝叶,而仅有4例患者有局限于单个肝叶的孤立性病灶。肝转移患者不太可能存活2年,中位生存期为10个月。
如果同时存在肝外疾病,子宫颈癌患者肝转移的良好模式并非生存良好的主要决定因素。