Surgical treatment for both pulmonary and hepatic metastases from colorectal cancer
Surgical treatment for both pulmonary and hepatic metastases from colorectal cancer
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DOI：
10.1016/s0022-5223(99)70106-6
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发表时间：
1999-12-01
影响因子：
6
通讯作者：
Ishihara, T
中科院分区：
文献类型：
--
作者：
Kobayashi, K;Kawamura, M;Ishihara, T
目的：手术在结直肠癌肺和肝转移患者治疗中的作用尚未明确。方法：在1988年6月至1996年6月期间，日本转移性肺肿瘤研究组的351例结直肠癌肺转移患者中，有47例也因转移性肿瘤进行了肝切除术。对这些病人的病历进行了研究。结果：47例行肺和肝切除术的患者3年生存率为36% +/- 8%，5年生存率为31% +/- 8%，8年生存率为23% +/- 9%。最长生存期为98个月。该患者存活，无复发。单发肺转移患者与多发肺转移患者的累积生存期差异有统计学意义（P = 0.04）。年龄、性别、原发肿瘤位置、肺转移灶最大直径、肺切除方式、肝转移灶数量、肝切除方式与生存率均无相关性。然而，10例首次开胸术后存活3年及以上的患者中有9例仅发生1例或2例肝转移灶。结论：如果结直肠癌的肝转移灶是可以切除治愈的，那么在肝转移灶切除的同时或之后，单发肺转移灶的手术治疗是合适的。孤立性肺转移和少量肝转移的患者是切除的良好候选者，可以预期长期生存。
Objective: The role of surgery in the treatment of patients with pulmonary and hepatic metastases from colorectal cancer has not been delineated. Methods: Of the 351 patients enrolled in the Metastatic Lung Tumor Study Group of Japan between June 1988 and June 1996 who underwent thoracotomy for pulmonary metastases from colorectal cancer, 47 also underwent hepatic resection for metastatic tumors. The records of these patients were studied. Results: The 47 patients who underwent pulmonary and hepatic resection had a 3-year survival of 36% +/- 8%, a 5-year survival of 31% +/- 8%, and an 8-year survival of 23% +/- 9%. The longest survival was 98 months. This patient was alive without recurrence. There was a significant difference in the cumulative survival of the patients with a solitary pulmonary metastasis and the patients with multiple pulmonary metastases (P = .04). Neither age, sex, location of the primary tumor, maximum diameter of the pulmonary metastases, method of pulmonary resection, number of hepatic metastases, nor method of hepatic resection was correlated with survival, However, 9 of 10 patients who survived 3 years or more after the initial thoracotomy had only one or two hepatic metastases. Conclusion: Surgical treatment of a solitary pulmonary metastasis concurrent with or after resection of hepatic metastases from colorectal cancer may be appropriate if the hepatic metastases are resectable for cure. Patients with a solitary pulmonary metastasis and a small number of hepatic metastases are good candidates for resection, Long-term survival can be expected.