Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer.
Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer.
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DOI：
10.14701/kjhbps.2016.20.3.110
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Kim KS
中科院分区：
文献类型：
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作者：
Lee SH;Kim SH;Lim JH;Kim SH;Lee JG;Kim DJ;Choi GH;Choi JS;Kim KS
积极的外科手术切除肝转移是有效的，然而，结直肠癌患者合并肝和肺转移是不明确的。对2008年1月至2012年12月收治的234例结直肠癌合并肝、肺转移患者的临床病理资料进行回顾性分析。对临床病理因素和生存资料进行分析。234例患者中，129例(55.1%)同时伴有结直肠癌肝、肺转移，36例(15.4%)为异时性转移。同期手术切除33例(25.6%)，异时转移6例(16.7%)。手术切除显示两组患者的总体存活率均较高(同步，p=0.001；异时，p=0.028)。在同步转移组中，完全切除肝和肺转移灶比不完全切除两个转移灶有更好的生存结果(p=0.037)。结直肠癌的原发部位和完全切除是影响预后的重要因素(p=0.06和p=0.003)。手术切除结直肠癌肝、肺转移灶可提高可切除病例的完全缓解和生存率。结直肠癌合并肝、肺转移并不是一个不良的预后因素，也不是外科治疗的禁忌症，因此，在可切除的病例中，可以推荐积极的手术方式。
Aggressive surgical resection for hepatic metastasis is validated, however, concomitant liver and lung metastasis in colorectal cancer patients is equivocal. Clinicopathologic data from January 2008 through December 2012 were retrospectively reviewed in 234 patients with colorectal cancer with concomitant liver and lung metastasis. Clinicopathologic factors and survival data were analyzed. Of the 234 patients, 129 (55.1%) had synchronous concomitant liver and lung metastasis from colorectal cancer and 36 (15.4%) had metachronous metastasis. Surgical resection was performed in 33 patients (25.6%) with synchronous and 6 (16.7%) with metachronous metastasis. Surgical resection showed better overall survival in both groups (synchronous, p=0.001; metachronous, p=0.028). In the synchronous metastatic group, complete resection of both liver and lung metastatic lesions had better survival outcomes than incomplete resection of two metastatic lesions (p=0.037). The primary site of colorectal cancer and complete resection were significant prognostic factors (p=0.06 and p=0.003, respectively). Surgical resection for hepatic and pulmonary metastasis in colorectal cancer can improve complete remission and survival rate in resectable cases. Colorectal cancer with concomitant liver and lung metastasis is not a poor prognostic factor or a contraindication for surgical treatments, hence, an aggressive surgical approach may be recommended in well-selected resectable cases.