Prognosis in patients with synchronous colorectal cancer metastases after complete resection of the primary tumor and the metastases
Prognosis in patients with synchronous colorectal cancer metastases after complete resection of the primary tumor and the metastases
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DOI：
10.1002/jso.25578
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发表时间：
2019-09-01
影响因子：
2.5
通讯作者：
Witzigmann, Helmut
中科院分区：
文献类型：
--
作者：
Stelzner, Sigmar;Radulova-Mauersberger, Olga;Witzigmann, Helmut
背景在转移性结直肠癌（CRC）患者中，同步转移被认为是一个负面的预后因素。我们调查了在多学科小组（MDT）指导下接受原发肿瘤和转移瘤完全大体切除（R 0/1）的IV期CRC患者的结局。方法从前瞻性数据库中检索所有伴有同步转移的结直肠癌患者。分析了2006年至2017年接受完全切除治疗的患者。各种因素，包括多个转移部位和复杂的程序，进行了研究。进行单变量和多变量总生存期（OS）计算。结果330例同步转移患者中，101例（30.6%）达到R 0/1状态，其中12例（11.9%）有多个转移部位。45例（44.6%）患者需要进行复杂手术。R 0/1患者组的5年OS为53.0%。多因素分析不能发现与预后相关的因素。结论大肠癌同时性转移患者采用现代化的治疗方法，可以改善预后。MDT做出的决定为三分之一的患者提供了治疗IV期疾病的潜在治疗方法。尽管治疗复杂转移的患者比例较高，需要复杂的手术，但我们仍获得了良好的5年OS率。
Background Synchronous metastases are considered a negative prognostic factor in patients with metastatic colorectal cancer (CRC). We investigated the outcomes of stage IV CRC patients undergoing complete gross resection (R0/1) of both the primary tumor and the metastases under the guidance of a multidisciplinary team (MDT). Methods All CRC patients with synchronous metastases were retrieved from a prospective database. Patients treated from 2006 to 2017 who underwent complete resection were analyzed. Various factors, including multiple metastatic sites and complex procedures, were investigated. Univariate and multivariate overall survival (OS) calculations were performed. Results Of 330 consecutive patients with synchronous metastases, 101 (30.6%) achieved an R0/1 status including 12 (11.9%) patients with multiple metastatic sites. Complex procedures were necessary in 45 (44.6%) patients. Five-year OS was 53.0% for the R0/1 patient group. Multivariate analysis could not detect factors associated with prognosis. Conclusions With modern treatment, the prognosis of patients with synchronous CRC metastases can be improved. Decisions made by a MDT offered one-third of patients a potentially curative approach to their stage IV disease. Despite the treatment of a high rate of patients with complex metastases necessitating complex procedures, we achieved a favorable 5-year OS rate.