Complete hepatic resection of metastases from leiomyosarcoma prolongs survival.
Complete hepatic resection of metastases from leiomyosarcoma prolongs survival.
复制标题
DOI：
10.1016/s1091-255x(98)80006-1
复制
发表时间：
1998-03-01
期刊：
影响因子：
--
通讯作者：
Choti, M A
中科院分区：
文献类型：
--
作者：
Chen, H;Pruitt, A;Choti, M A
尽管肝切除术已被证明可以延长选定的结直肠癌转移患者的生存期，但对其他转移性肿瘤的益处尚未得到证实。为了确定肝切除术是否在转移性平滑肌肉瘤的治疗中发挥作用，我们回顾了1984年至1995年间连续11例平滑肌肉瘤孤立转移瘤切除术患者的病历。所有肝切除术均为起源于内脏（n = 6）或腹膜后（n = 5）的平滑肌瘤。平均无病期16个月。11例原发性肿瘤中有5例被归类为低级别，而6例为高级别。肝切除术包括肝叶切除术或扩大肝叶切除术（n = 4）、肝段切除术和/或楔形切除术（n = 5）和复杂切除术（n = 2）。无手术死亡。所有患者肝切除后的中位生存期为39个月。接受肝转移瘤完全切除的患者（n = 6）的生存期显著长于接受不完全切除的患者（n = 5）（P = 0.03，对数秩检验）。此外，6例接受完全切除的患者中有5例在肝切除术后存活，中位随访时间为53个月。因此，在选定的内脏和腹膜后平滑肌瘤孤立性肝转移患者中，完全切除肝转移可延长生存期。
Although liver resection has been shown to prolong survival in selected patients with metastases from colorectal cancer, the benefit for other metastatic tumors is unproved. To determine whether hepatic resection has a role in the management of metastatic leiomyosarcoma, medical records from 11 consecutive patients who underwent resection of isolated metastases from leiomyosarcoma between 1984 and 1995 were reviewed. All liver resections were for leiomyosarcomas originating in the viscera (n = 6) or retroperitoneum (n = 5). The average disease-free interval was 16 months. Five of 11 primary tumors were classified as low grade, whereas six were high grade. Hepatic resections included lobectomy or extended lobectomy (n = 4), segmentectomy and/or wedge resection (n = 5), and complex resection (n = 2). There were no operative deaths. Median survival of all patients after liver resection was 39 months. Patients who underwent complete resection of hepatic metastases (n = 6) had a significantly longer survival than those who had incomplete resections (n = 5) (P = 0.03, log-rank test). Furthermore, five of six patients who underwent complete resection are alive after hepatectomy with a median follow-up of 53 months. Therefore, in selected patients with isolated liver metastases from visceral and retroperitoneal leiomyosarcomas, complete resection of hepatic metastases results in prolonged survival.