Risk factors for cancer recurrence or death within 6 months after liver resection in patients with colorectal cancer liver metastasis.
Risk factors for cancer recurrence or death within 6 months after liver resection in patients with colorectal cancer liver metastasis.
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DOI：
10.4174/astr.2016.90.5.257
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发表时间：
2016-05
影响因子：
1.4
通讯作者：
Suh SO
中科院分区：
文献类型：
--
作者：
Jung SW;Kim DS;Yu YD;Han JH;Suh SO
本研究的目的是寻找结直肠癌肝转移（CRCLM）肝切除术后早期复发（ER）和早期死亡（艾德）的危险因素。1990年5月至2011年12月，279例患者在高丽大学医学中心接受了CRCLM肝切除术。将其分为ER组（肝切除术后6个月内复发）或NER组（肝切除术后6个月内无复发）和艾德组（肝切除术后6个月内死亡）或N艾德组（肝切除术后存活> 6个月）。ER组包括30例患者（10.8%），NER组包括247例患者（89.2%）。艾德组包括18例患者（6.6%），N艾德组包括253例患者（93.4%）。单因素分析中ER的预后因素为低分化结直肠癌（CRC）、同步转移、肝脏肿块≥5 cm、术前癌胚抗原水平≥50 ng/mL、肝切除切缘阳性和仅手术而无围手术期化疗。单因素分析中，艾德的预后因素为低分化结直肠癌、肝切除切缘阳性和单纯手术而无围手术期化疗。多因素分析显示，低分化结直肠癌、转移灶大小≥5 cm、肝切缘阳性、单纯手术未行围手术期化疗是ER的独立危险因素。对于艾德，多因素分析显示，低分化结直肠癌、肝切除切缘阳性、单纯手术而未行围手术期化疗是其危险因素。当患者存在以下术前风险因素时，应仔细考虑完整的肝切除术，切除边缘清晰，围手术期化疗：转移性肿瘤大小≥ 5 cm，低分化CRC。
The aim of this study was to find risk factors for early recurrence (ER) and early death (ED) after liver resection for colorectal cancer liver metastasis (CRCLM). Between May 1990 and December 2011, 279 patients underwent liver resection for CRCLM at Korea University Medical Center. They were assigned to group ER (recurrence within 6 months after liver resection) or group NER (non-ER; no recurrence within 6 months after liver resection) and group ED (death within 6 months after liver resection) or group NED (alive > 6 months after liver resection). The ER group included 30 patients (10.8%) and the NER group included 247 patients (89.2%). The ED group included 18 patients (6.6%) and the NED group included 253 patients (93.4%). Prognostic factors for ER in a univariate analysis were poorly differentiated colorectal cancer (CRC), synchronous metastasis, ≥5 cm of liver mass, ≥50 ng/mL preoperative carcinoembryonic antigen level, positive liver resection margin, and surgery alone without perioperative chemotherapy. Prognostic factors for ED in a univariate analysis were poorly differentiated CRC, positive liver resection margin, and surgery alone without perioperative chemotherapy. Multivariate analysis showed that poorly differentiated CRC, ≥5-cm metastatic tumor size, positive liver resection margin, and surgery alone without perioperative chemotherapy were independent risk factors related to ER. For ED, poorly differentiated CRC, positive liver resection margin, and surgery alone without perioperative chemotherapy were risk factors in multivariate analysis. Complete liver resection with clear resection margin and perioperative chemotherapy should be carefully considered when patients have the following preoperative risk factors: metastatic tumor size ≥ 5 cm and poorly differentiated CRC.