Results of R0 resection for colorectal liver metastases associated with extrahepatic disease
Results of R0 resection for colorectal liver metastases associated with extrahepatic disease
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DOI：
10.1245/aso.2004.03.085
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发表时间：
2004-03-01
影响因子：
3.7
通讯作者：
Ducreux, M
中科院分区：
文献类型：
--
作者：
Elias, D;Sideris, L;Ducreux, M
背景：肝外恶性肿瘤一直被认为是结直肠癌肝转移切除术的绝对禁忌证。本研究报告的长期结果和预后因素的患者接受肝外疾病切除术，同时肝切除术的肝transferation.Methods：从1987年1月至2001年1月，75例患者接受了完整的R 0切除术的肝外疾病，同时肝切除术的结直肠肝转移。他们被登记在一个登记处，然后前瞻性地随访。他们代表了25%的294例患者接受了R 0肝切除术结直肠癌肝转移在同一时期。结果：死亡率为2.7%，发病率为25%。中位随访4.9年（范围1.7-13.4年）后，总体3年和5年生存率分别为45%和28%。通过使用考克斯模型，单部位肝外病变与多部位肝外病变患者的生存率有显著差异。此外，存在五个以上的肝转移是一个显着的parameter.Conclusions：肝外疾病结直肠癌肝转移患者不应再被认为是肝切除术的禁忌症。然而，这种预期的R 0切除术不能在50%的剖腹手术患者中进行，手术的负面预后因素包括存在多个肝外疾病部位或超过5个肝转移灶。
Background: Extrahepatic malignant disease has always been considered an absolute contraindication to hepatectomy for colorectal liver metastases. This study reports the long-term outcome and prognostic factors of patients undergoing extrahepatic disease resection simultaneously with hepatectomy for liver metastases.Methods: From January 1987 to January 2001, 75 patients underwent a complete R0 resection of extrahepatic disease simultaneously with hepatectomy for colorectal liver metastases. They were inscribed in a registry and then prospectively followed up. They represented 25% of the 294 patients who underwent an R0 hepatectomy for colorectal liver metastases during the same period.Results: The mortality rate was 2.7%, and morbidity was 25%. After a median follow-up of 4.9 years (range, 1.7-13.4 years), the overall 3- and 5-year survival rates were 45% and 28%, respectively. By using a Cox model, there was a significant difference in survival between patients with single versus multiple sites of extrahepatic disease. Also, the presence of more than five liver metastases was a significant parameter.Conclusions: Extrahepatic disease in colorectal cancer patients with liver metastases should no longer be considered as a contraindication to hepatectomy. However, this intended R0 resection cannot be performed in 50% of laparotomized patients, and negative prognostic factors for surgery include the presence of multiple extrahepatic disease sites or more than five liver metastases.