Title结直肠癌同时性肝转移同期与分期手术切除疗效比较
Other TitlesSimultaneous versus staged liver resection of synchronous liver metastasis from colorectal cancer
Authors王立军
闫晓峦
王崑
包全
孙谊
王宏伟
金克敏
邢宝才
Affiliation100142,北京大学肿瘤医院暨北京市肿瘤防治研究所肝胆胰外一科 恶性肿瘤发病机制及转化研究教育部重点实验室
Keywords结直肠肿瘤 肝转移,同时性 同期肝切除 分期肝切除 预后 Colorectal neoplasms Liver metastases,synchronous Simultaneous resection Staged resection Prognosis
Issue Date2014
Publisher中华胃肠外科杂志
Citation中华胃肠外科杂志.2014,(10),1009-1013.
Abstract目的:比较结直肠癌同时性肝转移患者原发灶和肝转移灶同期与分期切除的近期和远期结局。方法回顾性分析北京肿瘤医院肝胆胰外一科2003年1月至2011年12月间的64例结直肠癌合并同时性肝转移患者的临床及术后随访资料,其中行原发灶和肝转移灶同期切除者20例(同期切除组),分期切除者44例(分期切除组)。结果同期切除组Clavien-Dindo 1、2和3级并发症发生率分别为10.0%(2/20)、15.0%(3/20)和15.0%(3/20),分期切除组分别为13.6%(6/44)、13.6%(6/44)和22.7%(12/44),差异无统计学意义(P>0.05)。同期切除组1、2和3年总体生存率分别为85.0%、59.6%和37.2%,分期切除组分别为90.9%、68.2%和47.1%,差异亦无统计学意义(均P>0.05)。两组中位无病生存时间分别为6月和7月,差异亦无统计学意义(P>0.05)。多因素预后分析显示,原发灶淋巴结阳性(P=0.020)和肝切除术前CEA水平大于20μg/L(P=0.017)是影响患者总体生存的独立危险因素;复发后有机会接受根治性局部治疗联合化疗则是一项保护性因素(P=0.001);而手术时机(同期或分期切除)与患者总体生存无关(P>0.05)。结论对于结直肠癌同时性肝转移,选择同期或分期切除并不影响患者的术后并发症发生率和远期生存率。
To compare the short- and long-term outcomes of patients with synchronous colorectal liver metastases receiving either simultaneous or staged hepatectomy.Clinical and follow-up data of 64 patients with synchronous colorectal liver metastasis who underwent either simultaneous or staged hepatectomy between January 2003 and December 2011 in our hospital were reviewed retrospectively. Among them 20 patients underwent simultaneous resection of colorectal cancer and liver metastasis(simultaneous group) and 44 patients underwent staged operations(staged group).The Clavien-Dindo grade 1, 2, 3 complication rates in simultaneous group were 10.0%, 15.0% and 15.0% respectively, and were staged group 13.6%, 13.6% and 22.7% respectively in staged group, and the difference was not statistically significant(P>0.05). The 1-, 2- and 3-year overall survival rates in simultaneous group were 85.0%, 59.6% and 37.2% respectively, compared with 90.9%, 68.2% and 47.1% in staged group, and the difference was not statistically significant(P>0.05). The median disease-free survival time in simultaneous group was 6 months versus 7 months in the staged group, which was comparable(P>0.05). Multivariate analysis revealed that positive primary lymph-node(P=0.020), prehepatectomy CEA>20 μg/L(P=0.017) were independent risk factors of overall survival, and having the opportunity to receive local radical therapy combined with chemotherapy after recurrence was a protective factor(P=0.001), while the timing of resection (simultaneous or staged strategy) did not reach statistical significance according to overall survival(P>0.05).For synchronous colorectal liver metastasis there are no significant differences in postoperative complication rate and long-term survival between curative simultaneous and staged resection.
URIhttp://hdl.handle.net/20.500.11897/188584
ISSN1671-0274
DOI10.3760/cma.j.issn.1671-0274.2014.10.013
IndexedPubMed
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
Appears in Collections:北京肿瘤医院

Web of Science®



Checked on Last Week

Scopus®



Checked on Current Time

百度学术™



Checked on Current Time

Google Scholar™





License: See PKU IR operational policies.