Surgical management and outcomes of colorectal cancer liver metastases
Surgical management and outcomes of colorectal cancer liver metastases
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DOI：
10.1002/bjs.7032
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发表时间：
2010-07-01
影响因子：
9.6
通讯作者：
Poston, G.
中科院分区：
文献类型：
--
作者：
Morris, E. J. A.;Forman, D.;Poston, G.
背景资料：这项以人群为基础的研究探讨了频率肝切除结直肠癌转移在英格兰和他们的outcome.Methods：个人谁接受了手术结直肠癌1998年1月至2004年6月之间的英国国民健康服务通过国家癌症数据库。对初次手术后3年内的所有护理事件进行检查，以确定肝切除的频率。在使用肝切除术和生存率的变化进行了assessed.Results：约114155人在研究期间进行了手术结直肠癌，其中3116（2.7%）随后有一个或多个肝切除术。肝切除率从1998年的1.7%上升到2004年的3.8%。在癌症网络（1.1%-4.3%）和医院（0.7%-6.8%）之间，肝切除率存在显著差异。肝切除术后的5年生存率为44.2（95%置信区间（c.i.）42.4至46.1）%，从肝切除术时和45.9（95% c.i. 44.1至47.7%）。这与III期疾病患者的5年生存率（42.2（95% c.i. 41.7结论：肝转移瘤的切除率在研究期间有所增加，但在全国范围内差异显著。接受肝切除术的患者的5年生存率与III期结直肠癌患者相当。
Background: This population-based study investigated the frequency of hepatic resections for colorectal cancer metastases across England and their outcome.Methods: Individuals who underwent surgery for colorectal cancer between January 1998 and June 2004 within the English National Health Service were identified via the National Cancer Data Repository. All episodes of care in the 3 years after the initial operation were examined to determine the frequency of liver resection. Variations in the use of liver resection and survival were assessed.Results: Some 114 155 individuals underwent surgery for colorectal cancer over the study period, of whom 3116 (2.7 per cent) subsequently had one or more hepatic resections. The hepatectomy rate increased from 1.7 per cent in 1998 to 3.8 per cent in 2004. There was significant variation in the rate of liver resection across cancer networks (range 1.1-4.3 per cent) and hospitals (range 0.7-6.8 per cent). The crude 5-year survival rate after liver resection was 44.2 (95 per cent confidence interval (c.i.) 42.4 to 46.1) per cent from the time of hepatectomy and 45.9 (95 per cent c.i. 44.1 to 47.7) per cent from the time of colectomy. This was comparable to the 5-year survival rate of patients with stage III disease (42.2 (95 per cent c.i. 41.7 to 42.7) per cent).Conclusion: The rate of resection of liver metastases increased over the study period but varied significantly across the country. Patients who underwent liver resection had 5-year survival comparable to that of patients with stage III colorectal cancer.