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中华普通外科学文献(电子版) ›› 2010, Vol. 04 ›› Issue (03) : 203 -207. doi: 10.3877/cma.j.issn.1674-0793.2010.03.005

所属专题: 文献

论著

手术切除结直肠癌肝多个转移瘤的效果分析
邱际亮1, 元云飞1,(), 李斌奎1, 卢灿亮1, 徐瑞华2, 潘志忠3, 李锦清1, 张亚奇1, 万德森3   
  1. 1. 510060 华南肿瘤学国家重点实验室;中山大学肿瘤防治中心肝胆科
    2. 510060 华南肿瘤学国家重点实验室;中山大学肿瘤防治中心内科
    3. 510060 华南肿瘤学国家重点实验室;中山大学肿瘤防治中心结直肠科
  • 收稿日期:2010-01-25 出版日期:2010-06-01
  • 通信作者: 元云飞

Outcome of hepatectomy for patients with multiple hepatic metastases from colorectal cancer

Ji-liang QIU1, Yun-fei YUAN1,(), Bin-kui LI1, Can-liang LU1, Rui-hua XU2, Zhi-zhong PAN3, Jin-qing LI1, Ya-qi ZHANG1, De-sen WAN3   

  1. 1. Sun Yat-sen University Cancer Center, Guangzhou 510060, China
  • Received:2010-01-25 Published:2010-06-01
  • Corresponding author: Yun-fei YUAN
  • About author:
    Corresponding author: YUAN Yun-fei, Email:
引用本文:

邱际亮, 元云飞, 李斌奎, 卢灿亮, 徐瑞华, 潘志忠, 李锦清, 张亚奇, 万德森. 手术切除结直肠癌肝多个转移瘤的效果分析[J/OL]. 中华普通外科学文献(电子版), 2010, 04(03): 203-207.

Ji-liang QIU, Yun-fei YUAN, Bin-kui LI, Can-liang LU, Rui-hua XU, Zhi-zhong PAN, Jin-qing LI, Ya-qi ZHANG, De-sen WAN. Outcome of hepatectomy for patients with multiple hepatic metastases from colorectal cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(03): 203-207.

目的

对于结直肠癌患者肝内存在多个转移瘤,手术切除的价值存在争议,本文旨在研究手术切除大肠癌肝多个转移瘤的效果。

方法

回顾性分析1996年1月至2006年12月收治的经手术切除的结直肠癌肝转移瘤患者60例,比较肝内单个转移瘤(35例)与多个转移瘤(25例)患者临床和预后资料。

结果

两组均无手术死亡。多个转移瘤组和单个转移瘤组相比,手术并发症为12.0% vs 11.4%(P=1.000);平均住院时间为(14.9±5.1)d vs(15.7±5.8)d(P=0.844);中位生存期为28个月vs 35个月(P=0.089);中位无瘤生存期为16个月vs 19个月(P=0.112);肝内复发率为72.0% vs 51.5%(P=0.109)。多个转移瘤组3、5年总生存率分别是48.4%、30.8%,单个转移瘤组分别为68.6%、57.7%(P=0.165)。

结论

手术切除结直肠癌肝脏多个转移瘤可取得与单个转移瘤相似的效果。手术切除不应视为肝多个转移瘤的禁忌证。术后辅以全身化疗常可以改善预后。

Objective

Survival benefit of resection for multiple liver metastases has not been established. This study was to investigate the effect of resection of multiple hepatic colorectal metastases.

Methods

Sixty patients with liver metastases from colorectal cancer received liver resection from Jan 1996 to Dec 2006, including 25 cases with two or more liver metastases, 35 with solitary liver metastasis. Clinical and outcome data were retrospectively analyzed between multiple liver metastases and solitary liver metastasis.

Results

The perioperative morbidity rate was 12.0% in multiple metastases group and 11.4% in solitary metastasis group (P=1.000), and no mortality in either group. The respective mean hospital duration was (14.9±5.1) days and (15.7±5.8) days (P=0.844), the median overall survival (OS) time was 28 and 35 months (P=0.089), the median disease free survival (DFS) time was 16 and 19 months (P=0.112), and the intrahepatic recurrence rates were 72.0% and 51.5% (P=0.109). The 3- and 5-year overall survival rates were 48.4%, and 30.8%, respectively, in multiple metastases group and 68.6%, 57.7%, respectively, in solitary metastasis group (P=0.165).

Conclusions

There is no significant differences of OS time and DFS time in two groups. Liver resection is not a contraindication for multiple liver metastases. In the current era of effective chemotherapy, aggressive approach with hepatectomy, followed by adjuvant chemotherapy could offer an improved prognosis for multiple liver metastases from colorectal carcinoma.

表1 60例结直肠癌肝转移瘤手术切除的临床资料
图1 单个转移瘤组和多个转移瘤组总生存曲线(A)和无瘤生存曲线(B)
表2 60例结直肠癌肝转移患者的手术治疗结果
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