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

doi:10.3877/cma.j.issn.1674-0793.2010.03.005

Abstract

Abstract:

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.

Key words: Colorectal neoplasms, Liver metastases/secondary, Hepatectomy, Prognosis

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]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(03): 203-207.

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Figures/Tables 3

References 20

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临床病理参数		多个转移瘤组	单个转移瘤组	P值
例数		25	35	?
?	性别	?	?	?
?	男	18	21	0.337
?	女	7	14	?
年龄(岁)		?	?	0.190
?	≤60	15	15	?
?	>60	10	20	?
原发病灶		?	?	1.000
?	结肠	17	16	?
?	直肠	8	19	?
肿瘤直径(cm)		?	?	0.265
?	≤5	14	27	?
?	>5	11	8	?
同/异时性		?	?	1.000
?	同时性	22	32	?
?	异时性	3	3	?
血清CEA(μg/L)		?	?	0.195
?	≥100	18	31	?
?	<100	7	4	?
组织学分级		?	?	0.113
?	高	2	3	?
?	中	16	29	?
?	低	7	3	?
肿瘤浸润分期		?	?	0.831
?	T1~3	21	27	?
?	T4	3	6	?
?	未知	1	2	?
淋巴结分期		?	?	0.488
?	N0	8	11	?
?	N1	9	19	?
?	N2	6	3	?
?	未知	2	2	?
术中输血		?	?	0.087
?	是	5	6	?
?	否	20	29	?
解剖性切除		?	?	0.319
?	是	11	11	?
?	否	14	24	?
接受辅助性化疗		?	1.000	?
?	是	22	31	?
?	否	3	4	?
化疗方案		?	0.015	?
?	亚叶酸钙+氟脲嘧啶为主	0	8	?
?	奥沙利铂为主	22	23	?

临床病理参数		多个转移瘤组	单个转移瘤组	P值
例数		25	35	?
?	性别	?	?	?
?	男	18	21	0.337
?	女	7	14	?
年龄(岁)		?	?	0.190
?	≤60	15	15	?
?	>60	10	20	?
原发病灶		?	?	1.000
?	结肠	17	16	?
?	直肠	8	19	?
肿瘤直径(cm)		?	?	0.265
?	≤5	14	27	?
?	>5	11	8	?
同/异时性		?	?	1.000
?	同时性	22	32	?
?	异时性	3	3	?
血清CEA(μg/L)		?	?	0.195
?	≥100	18	31	?
?	<100	7	4	?
组织学分级		?	?	0.113
?	高	2	3	?
?	中	16	29	?
?	低	7	3	?
肿瘤浸润分期		?	?	0.831
?	T1~3	21	27	?
?	T4	3	6	?
?	未知	1	2	?
淋巴结分期		?	?	0.488
?	N0	8	11	?
?	N1	9	19	?
?	N2	6	3	?
?	未知	2	2	?
术中输血		?	?	0.087
?	是	5	6	?
?	否	20	29	?
解剖性切除		?	?	0.319
?	是	11	11	?
?	否	14	24	?
接受辅助性化疗		?	1.000	?
?	是	22	31	?
?	否	3	4	?
化疗方案		?	0.015	?
?	亚叶酸钙+氟脲嘧啶为主	0	8	?
?	奥沙利铂为主	22	23	?

临床因素		多个转移瘤组	单个转移瘤组	P值
平均住院天数(d)		14.9±5.1	15.7±5.8	0.844
并发症发生率(%)		12.0	11.4	1.000
中位生存时间(月)		28	35	0.089
中位无瘤生存时间(月)		16	19	0.112
肝内复发率(%)		72.0	51	0.109
总生存率(%)		?	?	0.165
?	1年	100.0	97.0	1.000
?	3年	48.4	68.6	0.109
?	5年	30.8	57.7	0.054
无瘤生存率(%)		?	?	0.296
?	1年	68.0	72.7	0.594
?	3年	25.8	41.8	0.131
?	5年	25.8	41.8	0.131

临床因素		多个转移瘤组	单个转移瘤组	P值
平均住院天数(d)		14.9±5.1	15.7±5.8	0.844
并发症发生率(%)		12.0	11.4	1.000
中位生存时间(月)		28	35	0.089
中位无瘤生存时间(月)		16	19	0.112
肝内复发率(%)		72.0	51	0.109
总生存率(%)		?	?	0.165
?	1年	100.0	97.0	1.000
?	3年	48.4	68.6	0.109
?	5年	30.8	57.7	0.054
无瘤生存率(%)		?	?	0.296
?	1年	68.0	72.7	0.594
?	3年	25.8	41.8	0.131
?	5年	25.8	41.8	0.131

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