Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: a propensity score matching analysis
Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: a propensity score matching analysis
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原发肿瘤位置影响结直肠肝转移患者肝切除术后的无复发生存：倾向评分匹配分析
DOI：
10.1186/s12957-020-01875-y
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发表时间：
2020-03
影响因子：
3.2
通讯作者：
Li Binkui
中科院分区：
文献类型：
--
作者：
Zhang Yuanping;Wang Yongjin;Yuan Yichuan;Qiu Jiliang;Qiu Yuxiong;He Wei;Zheng Yun;Wang Zhiqiang;Gu Yangkui;Lu Zhenhai;Chen Gong;Ding Peirong;Wu Xiaojun;Pan Zhizhong;Wan Desen;Li Yuhong;Xu Ruihua;Yuan Yunfei;Li Binkui
背景结直肠癌（CRC）的原发肿瘤位置是否影响肝转移切除术后患者的生存仍存在争议。本研究旨在探讨肝切除术后右侧结直肠癌和左侧结直肠癌肝转移患者临床病理特征及预后的差异。方法回顾性分析2002年至2018年在我中心接受肝切除术的611例结直肠肝转移（CRLM）患者。原发肿瘤位于盲肠至横结肠的定义为右侧组（n=141）；位于脾曲至直肠的肿瘤被定义为左侧组（n=470）。对两组患者进行1:1倾向评分匹配（PSM）分析前后进行比较。结果PSM前，右侧组中位生存时间和5年总生存（OS）率分别为77个月和56.3%，左侧组分别为64个月和51.1%。 PSM后，右侧组的中位生存时间和5年OS率分别为77个月和55.9%，左侧组的中位生存时间和5年OS率分别为58.8个月和47.3%。 PSM前后两组OS率无差异（P=0.575，P=0.453）。然而，右侧组和左侧组在PSM前后的无复发生存率（RFS）存在显着差异（P=0.028，P=0.003）。结论与左侧原发肿瘤患者相比，右侧原发肿瘤患者的RFS较差，但OS相似。对于右侧原发肿瘤的 CRLM 患者，仔细的术前评估、强化术前化疗和频繁随访以检测早期复发可能是合理的。
BackgroundWhether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy.MethodsFrom 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from the cecum to transverse colon were defined as right-sided group (n= 141); tumors located from the splenic flexure to rectum were defined as left-sided group (n= 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis.ResultsBefore PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did notdiffer between two groups before and after PSM (P= 0.575,P= 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P= 0.028,P= 0.003).ConclusionsCompared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy, and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.
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影响因子：
5.3
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通讯作者：
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3.7
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Vauthey JN