Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer - Long-term results
Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer - Long-term results
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DOI：
10.1097/00000658-200004000-00006
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发表时间：
2000-04-01
影响因子：
9
通讯作者：
Imamura, H
中科院分区：
文献类型：
--
作者：
Minagawa, M;Makuuchi, M;Imamura, H
目的回顾性评价长期的结果，包括在每个患者中进行手术，根治性切除所有转移性疾病在技术上是可行的。摘要背景DataThe适应症手术切除结直肠癌肝转移仍有争议。据报道，几个临床风险因素影响生存率。方法1980年3月至1997年12月，235例转移性结直肠癌行肝切除术。生存率和无病生存作为一个功能的临床和病理学的决定因素进行了回顾性研究与单变量和多变量analysis.ResultsThe整体3，5，10，和15年的生存率分别为51%，38%，26%，和24%，分别。在单因素和多因素分析中，原发肿瘤的分期、淋巴结转移和多发结节与预后不良显著相关。淋巴结转移、原发性和转移性肿瘤治疗间隔时间短以及术前癌胚抗原水平高对无病生存率有显著影响。结直肠癌肝转移伴4个及以上结节者10年生存率（29%）高于2 ~ 3个结节者（16%），与单发者（32%）相近。虽然多发性转移显著损害预后，但有四个或更多结节的患者的预期寿命要求切除。
ObjectiveTo evaluate retrospectively the long-term results of an approach consisting of performing surgery in every patient in whom radical removal of all metastatic disease was technically feasible.Summary Background DataThe indications for surgical resection for liver metastases from colorectal cancer remain controversial. Several clinical risk factors have been reported to influence survival. MethodsBetween March 1980 and December 1997, 235 patients underwent hepatic resection for metastatic colorectal cancer. Survival rates and disease-free survival as a function of clinical and pathologic determinants were examined retrospectively with univariate and multivariate analyses.ResultsThe overall 3-, 5-, 10-, and 15-year survival rates were 51%, 38%, 26%, and 24%, respectively. The stage of the primary tumor, lymph node metastasis, and multiple nodules were significantly associated with a poor prognosis in both univariate and multivariate analyses. Disease-free survival was significantly influenced by lymph node metastasis, a short interval between treatment of the primary and metastatic tumors, and a high preoperative level of carcinoembryonic antigen. The 10-year survival rate of patients with four or more nodules (29%) was better than that of patients with two or three nodules (16%), and similar to that of patients with a solitary lesion (32%).ConclusionsSurgical resection is useful for treating liver metastases from colorectal cancer. Although multiple metastases significantly impaired the prognosis, the life expectancy of patients with four or more nodules mandates removal.