Patterns of recurrence after liver transplantation for nonresectable liver metastases from colorectal cancer.
Patterns of recurrence after liver transplantation for nonresectable liver metastases from colorectal cancer.
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结直肠癌不可切除肝转移肝移植后的复发模式。
DOI：
10.1245/s10434-013-3449-9
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发表时间：
2014-04
影响因子：
3.7
通讯作者：
Dueland S
中科院分区：
文献类型：
--
作者：
Hagness M;Foss A;Egge TS;Dueland S
手术切除是结直肠癌肝转移（CLM）的唯一治愈方式，切除后复发的模式影响生存率。在一项肝移植治疗不可切除CLM的前瞻性研究中，我们发现5年总生存率为60%，但21例中有19例复发。本研究报告了CLM Lt后复发的模式以及对生存的影响。对不可切除CLM的Lt前瞻性研究中的转移性病变进行了表征（n = 21）。该研究包括重新检查胸部计算机断层扫描之前采取的第一次复发时，16个是一个单一的网站，3个是多个网站。13个单一部位为肺复发。肺复发出现早，生长缓慢，少数可手术治疗。当重新检查胸部计算机断层扫描时，7名患者在Lt时有肺结节，但对生存率没有影响。无首次单部位肝脏复发。7名发生移植肝转移的患者中有6名死于转移性疾病。CLM Lt后的肺复发是无痛性的，即使是那些在Lt时存在的肺复发。这与移植肝转移的发现形成对比，这是病理学上的不良反应。缺乏单一的肝脏第一部位复发和肝转移只是作为播散性疾病的一部分，这与肝切除术后复发的模式不同。这表明CLM切除后肝复发有两种不同的机制。
Surgical resection is the only curative modality for colorectal liver metastases (CLM), and the pattern of recurrences after resection affects survival. In a prospective study of liver transplantation (Lt) for nonresectable CLM we have shown a 5-year overall survival rate of 60 %, but 19 of 21 experienced recurrence. This study reports the pattern of recurrences after Lt for CLM and the effect on survival. Characterization of metastatic lesions in a prospective study for Lt for nonresectable CLM was performed (n = 21). The study included reexamination of chest computed tomographic scans taken before Lt. At the time of first recurrence, 16 were a single site, and three were multiple sites. Thirteen of the single sites were pulmonary recurrences. The pulmonary recurrences appeared early and were slow growing, and several were accessible to surgical treatment. When chest computed tomographic scans were reexamined, seven patients had pulmonary nodules at the time of Lt without an effect on survival. There was no first single-site hepatic recurrence. Six of the seven patients who developed metastases to the transplanted liver died from metastatic disease. The pulmonary recurrences after Lt for CLM were of an indolent character, even those that were present at the time of Lt. This contrasts with the finding of metastases to the transplanted liver, which was prognostically adverse. The lack of single hepatic first-site recurrences and hepatic metastases only as part of disseminated disease is different from the pattern of recurrence after liver resection. This suggests two distinct mechanisms for hepatic recurrences after resection for CLM.
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影响因子：
3.7
作者：
St Hill, Charles R.;Chagpar, Ryaz B.;Scoggins, Charles R.
通讯作者：
Scoggins, Charles R.
影响因子：
9
作者：
Hagness, Morten;Foss, Aksel;Dueland, Svein
通讯作者：
Dueland, Svein
DOI：
10.1053/ejso.2002.1421
发表时间：
2003-04-01
期刊：
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY
影响因子：
--
作者：
Topal, B;Kaufman, L;Penninckx, F
通讯作者：
Penninckx, F
影响因子：
3.8
作者：
Roth ES;Fetzer DT;Barron BJ;Joseph UA;Gayed IW;Wan DQ
通讯作者：
Wan DQ
影响因子：
3.7
作者：
Ammori, John B.;Kemeny, Nancy E.;D'Angelica, Michael I.
通讯作者：
D'Angelica, Michael I.