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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ΚΣ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%vs11.4%(P=1.000);平均住院时间为(14.9±5.1)dvs(15.7±5.8)d(P=0.844);中位生存期为28个月vs35个月(P=0.089);中位无瘤生存期为16个月vs19个月(P=0.112);肝内复发率为72.0%vs51.5%(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 For the colorectal cancer patients with multiple metastases in the liver, the value of surgical resection is controversial. This article aims to study the effect of surgical resection of multiple liver tumors in colorectal cancer. Methods Retrospective analysis of 60 patients with hepatic metastases from colorectal cancer undergoing surgery from January 1996 to December 2006 was retrospectively performed. The clinical comparisons of intrahepatic single metastases (35 cases) and multiple metastases (25 cases) were performed. And prognosis data. Results No operative mortality occurred in both groups. The surgical complication rate was 12.0% vs 11.4% for multiple metastases and single metastases (P=1.000); the average hospital stay was (14.9±5.1) dvs (15.7±5.8) days (P=0.844). The median survival time was 28 months vs 35 months (P=0.089); the median tumor free survival was 16 months vs 19 months (P=0.112); the intrahepatic recurrence rate was 72.0% vs 51.5% (P =0.109). The 3 and 5-year overall survival rates of multiple metastases were 48.4% and 30.8%, respectively, and 68.6% and 57.7% in a single metastatic group (P=0.165). Conclusion Surgical removal of multiple metastases from colorectal liver can achieve similar effects as single metastases. Surgical resection should not be considered as a contraindication for multiple metastatic liver tumors. Postoperative adjuvant chemotherapy can often improve prognosis.