Repeat hepatic resection as effective treatment for recurrent colorectal liver metastases
Repeat hepatic resection as effective treatment for recurrent colorectal liver metastases
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DOI：
10.1007/bf02303794
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发表时间：
1997-03
影响因子：
3.7
通讯作者：
T. Tuttle;S. Curley;M. Roh
中科院分区：
文献类型：
--
作者：
T. Tuttle;S. Curley;M. Roh
背景：大约 20-40% 因结直肠转移而接受肝切除的患者会出现局限于肝脏的复发性疾病。本研究的目的是确定重复肝切除术的生存获益是否足以证明潜在的发病率和死亡率。方法：对 1983 年至 1995 年间因结直肠癌转移而接受肝切除术的所有患者 (N=202) 进行回顾性分析。 23例复发转移患者再次行肝切除术。结果：23例患者无手术死亡，术后发病率为22%。重复切除后5年精算生存率为32%，中位生存期为39.9个月。有 3 名患者在重复切除后存活超过 5 年。 16 名患者 (70%) 在第二次切除后平均间隔 11 个月出现复发；这16名患者中有10名（62%）出现新的肝转移。没有临床或病理因素对预测长期生存具有显着意义。结论：针对复发性结直肠转移瘤的重复肝切除术（a）可以安全地进行，死亡率和发病率可接受，并且（b）可能导致某些患者长期生存。
Background: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.Methods: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.Results: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.Conclusions: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.