Mutsaerts Eduard L A R, van Ruth Serge, Zoetmulder Frans A N, Rutgers Emiel J T, Hart Augustinus A M, van Coevorden Frits
Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands.
J Gastrointest Surg. 2005 Feb;9(2):178-86. doi: 10.1016/j.gassur.2004.06.005.
The aim of this study was to determine prognostic factors and outcome after liver resection for colorectal metastases in 102 patients over a period of 10 years. A stepwise procedure using proportional hazard regression analysis was used to identify prognostic factors. Estimated survival at 2 years was 71%, and at 5 years, 29% (Kaplan-Meier). Of 19 patients with isolated liver recurrence, 6 had a second metastasectomy; 4 of the 6 are still alive. We found that the number of hepatic lesions on computed tomography (P=0.012), the interval between resection of the primary colon tumor and the hepatic metastasectomy (P=0.012), and synchronicity of the primary and the hepatic metastasis (P=0.048) showed evidence of independent prognostic value regarding survival. Resection of hepatic colorectal metastases may result in long-term survival. Patients with recurrence after a first liver resection may benefit from a repeat metastasectomy. Our data suggest there is no strong predictor of survival. Survival seems to decrease with increasing number of metastases found on computed tomography.
本研究的目的是确定102例患者在10年期间接受结直肠癌肝转移灶切除术后的预后因素及结局。采用比例风险回归分析的逐步程序来识别预后因素。2年估计生存率为71%,5年为29%(Kaplan-Meier法)。在19例孤立性肝复发患者中,6例接受了二次转移灶切除术;其中4例仍存活。我们发现,计算机断层扫描显示的肝内病灶数量(P = 0.012)、原发性结肠肿瘤切除与肝转移灶切除术之间的间隔时间(P = 0.012)以及原发性和肝转移的同步性(P = 0.048)在生存方面显示出独立的预后价值证据。结直肠癌肝转移灶切除术可能带来长期生存。首次肝切除术后复发的患者可能从再次转移灶切除术中获益。我们的数据表明,没有强有力的生存预测指标。生存似乎随着计算机断层扫描发现的转移灶数量增加而降低。