Patterns of failure following curative resection of colorectal liver metastases
Patterns of failure following curative resection of colorectal liver metastases
复制标题
DOI：
10.1053/ejso.2002.1421
复制
发表时间：
2003-04-01
期刊：
影响因子：
--
通讯作者：
Penninckx, F
中科院分区：
文献类型：
--
作者：
Topal, B;Kaufman, L;Penninckx, F
目的：一些研究集中在结直肠癌肝转移（LM）根治性切除术后复发和生存率的决定因素。数据缺乏关于失败的模式，表明在哪里和何时复发arising.Methods：100和5个连续的患者[F/M：31/74;平均年龄61岁（范围36-80 y）]与原发性结直肠肝转移进行手术R 0根治性切除术之间的1990-1999年。患者随访于2002年1月结束。生存分析采用共同截止日期法。多因素分析采用考克斯比例风险技术。结果：总的（CI）与无病生存率（DFS）在1年，2年和5年分别为88.5比63.3%，73.4比40.2%，36.8比18.1%。血清CEA水平升高是与复发疾病独立相关的唯一因素。血清CEA水平升高，肝转移瘤（LM）的最大直径，和卫星是显着相关的因素，以穷人OS。复发性肝转移发展在43%和60%的患者肝外转移。在大约一半的患者中，观察到癌症复发在18个月内，几乎均匀分布在肝和肝外sites.Conclusion：尽管最佳的患者选择和根治性切除结直肠癌肝转移，超过一半的患者在2年内癌症复发。(C)2003爱思唯尔科技有限公司版权所有。
Aims: Several studies have focused on factors determining recurrence and survival rate after curative resection of colorectal liver metastases (LM). Data are lacking with regard to patterns of failure indicating where and when recurrences arise.Methods: One-hundred-and-five consecutive patients [F/M: 3 1/74; mean age 61 years (range 36-80 y)] with primary colorectal liver metastases underwent surgical R0 curative resection between 1990-1999. Patient follow-up was closed in January 2002. The common closing date method was used for survival analysis. Multivariate analysis was performed with the Cox proportional hazard technique.Results: The overall (Cl vs disease free survival (DFS) rates at 1, 2, and 5 years were 88.5 vs 63.3, 73.4 vs 40.2, and 36.8 vs 18.1%, respectively. Elevated serum CEA level was the only factor independently related to recurrent disease. Elevated serum CEA level, maximum diameter of liver metastases (LM), and satellitosis were factors significantly related to poor OS. Recurrent liver metastases developed in 43% and extra-hepatic metastases in 60% of the patients. In about half of the patients cancer recurrence was observed within 18 months, almost equally distributed between hepatic and extra-hepatic sites.Conclusion: Despite optimal patient selection and curative resection of colorectal liver metastases, more than a half of the patients developed cancer recurrence within 2 years. (C) 2003 Elsevier Science Ltd. All rights reserved.