Influence of the primary tumour location in patients undergoing surgery for colorectal liver metastases
Influence of the primary tumour location in patients undergoing surgery for colorectal liver metastases
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DOI：
10.1016/j.ejso.2017.10.218
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发表时间：
2018-01-01
期刊：
影响因子：
3.8
通讯作者：
Poston, Graeme J.
中科院分区：
文献类型：
--
作者：
Dupre, Aurelien;Malik, Hassan Z.;Poston, Graeme J.
背景：原发灶位于右侧时，结直肠癌肝转移(CLM)行肝切除术的患者的预后似乎会发生改变。然而，数据缺乏，而且相互矛盾。我们的目的是评估原发肿瘤的位置对此类手术后肿瘤学结果的影响。方法：我们前瞻性地分析了2010年6月至2015年8月连续376例接受肝手术治疗的CLM患者的数据。我们比较了右半结肠肿瘤患者和左半结肠肿瘤患者的结果。结果：在364例符合条件的患者中，74例(20.3%)为右侧原发肿瘤。这些患者年龄较大，美国麻醉师协会的状况较差，结节阳性的原发肿瘤较少。两组的CLM特征相似。中位PFS在9.9个月时在两组之间以及复发模式方面没有显著差异。右侧原发肿瘤患者的中位OS较短(34.6月比45.3月，p=0.035)。在排除直肠肿瘤患者(34.6月vs.47.5月，p=0.007)的分析中也观察到了类似的结果。结论：原发肿瘤位于右侧与CLM术后较差的OS有关，但似乎对PFS和复发模式没有影响。(C)2017年爱思唯尔有限公司、类似于癌症外科协会的BASO和欧洲外科肿瘤学学会。版权所有。
Background: The prognosis of patients undergoing liver resection for colorectal liver metastases (CLM) seems to be altered when the primary tumour is right-sided. However, data are lacking and conflicting. We aimed to evaluate the influence of the primary tumour location on oncologic outcomes following such surgery.Methods: We retrospectively analysed prospectively collected data from 376 consecutive patients who underwent liver surgery for CLM between June 2010 and August 2015. We compared the outcomes of patients with right colon tumours and those with left colorectal tumours. The splenic flexure was used as the cut-off point to determine the anatomic primary site.Results: Among the 364 patients eligible, 74 (20.3%) had a right-sided primary tumour. These patients were older, had a poorer American Society of Anaesthesiologists status and had fewer node-positive primary tumours. The CLM characteristics were similar between both groups. Median PFS was not significantly different between the two groups at 9.9 months, as well as the pattern of recurrence. Median OS was shorter for patients with right-sided primary tumour (34.6 versus 45.3 months, p = 0.035). Similar results were observed when patients with rectal tumour were excluded from analysis (34.6 vs. 47.5 months, p = 0.007). Primary tumour site was an independent prognosis factor in multivariate analysis.Conclusion: Right-sided location of the primary tumour is associated with worse OS after surgery for CLM, but seems to have no influence on PFS, and on the pattern of recurrence. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.