A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer
A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer
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DOI：
10.1002/bjs.5278
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发表时间：
2006-04-01
影响因子：
9.6
通讯作者：
Launoy, G
中科院分区：
文献类型：
--
作者：
Leporrier, J;Maurel, J;Launoy, G
背景资料：这项以人群为基础的研究的目的是评估与结肠直肠癌相关的肝转移患者的发病率，管理和预后使用的数据从消化系统癌症登记处的Calvados.Methods：1325例结直肠癌患者登记1994年1月至1999年12月，358肝转移。Logistic回归分析影响预后的因素。生存分析进行了考克斯的比例风险model.Results：一些18.8%的患者有同步转移，而29.3%的发展转移在3年。在肝转移患者中，17.3%接受了手术切除，40.2%接受了姑息化疗，42.5%接受了对症治疗。与仅接受对症治疗相关的因素-年龄超过75岁和一个以上的转移，但不包括治疗地点。诊断为肝转移后的中位生存期为10-7（范围4.6-23。1)个月显著的不良预后因素为：年龄> 75岁（P = 0.001），淋巴结侵犯原发灶（P = 0.024），双侧转移分布（P = 0-001），其他转移（P = 0.004）和仅对症治疗结论：尽管肝转移瘤的治疗方法有所改进，但年龄和病变程度仍然是手术切除和姑息化疗的限制因素。
Background: The aim of this population-based study was to evaluate the incidence, management and prognosis of patients with hepatic metastases related to colorectal cancer using data from the Digestive Cancer Registry of Calvados, France.Methods: Of 1325 patients with colorectal cancer registered between January 1994 and December 1999, 358 developed hepatic metastases. Logistic regression was used to analyse prognostic factors. Survival analysis was carried out with Cox's proportional hazards model.Results: Some 18.8 per cent of patients had synchronous metastases, while 29.3 per cent developed metastases at 3 years. Of patients with hepatic metastases, 17.3 per cent had a surgical resection, 40.2 per cent were treated with palliative chemotherapy and 42.5 per cent had symptomatic treatment. Factors associated with receiving symptomatic treatment only -.vere age over 75 years and more than one metastasis, but not place of treatment. Median survival after a diagnosis of hepatic metastases was 10-7 (range 4.6-23. 1) months. Significant adverse prognostic factors were: age over 75 years (P = 0.001), lymph node invasion of primary turnout (P = 0.024), bilateral distribution of metastases (P = 0-001), other metastases (P = 0.004) and symptomatic treatment only (P = 0.041).Conclusion: Despite improvement in treatment for hepatic metastases, age and extent of disease remain limiting factors for surgical resection and palliative chemotherapy.