摘要
目的肝脏是结、直肠癌常见的转移部位,35%的患者在确诊时已发生肝转移,肝转移患者的预后较差。尽管手术切除、化疗、射频消融术、介入治疗等手段应用于临床,但治疗效果不同,该研究探讨结、直肠癌肝转移综合治疗的临床疗效。方法对该院1999～2006年经病理检查证实的396;例结、直肠癌肝转移患者的临床资料进行回顾性分析。根据治疗方法的不同进行分组,根治性切除组92例(29.2%),姑息性切除组86例(21.7%),手术探察组和支持治疗组58例(14.6%),肝动脉介入化疗组82例(20.7%),全身化疗组78例(19.7%),对其生存期进行比较和统计学分析。结果根治性切除组中位期37.1个月,5年生存率为31.2%。姑息性切除组的中位生存期14.3个月,5年生存率为0。肝动脉介入化疗组的中位生存期为21.3个月,5年生存率为7.5%。全身化疗中位生存期18.7个月,5年生存率为0。探察组和支持治疗组中位生存期6.3个月。根治性切除组与其他组比较,中位生存期有统计学意义(P<0.01)。结论根治性切除是提高结、直肠癌肝转移患者生存率的重要手段,姑息性切除治疗效果并不优于辅助性治疗,对不能根治性切除的患者可采用肝动脉介入化疗和全身化疗。
[Objective] Liver is the most common site of metastasis in colorectal cancer, and 35% patients with colorectal cancer developed liver metastasis at diagnosis. The prognosis of the patients with liver metastases from colorectal cancer is poor. Surgical resection, radiofrequency ablation, and chemotherapy had been used in clinical treatment for liver metastasis from colorectal cancer with various outcomes. This study was to explore the treatment efficacy of surgical management for liver metastasis from colorectal cancer. [Methods] Clinical datas of 396 patients with liver metastasis from colorectal cancer which were confimmed by pathological examination from Jan.1999 to Jan. 2006 were studied retrospectively. Of the 396 patients, 92 （23.2%） cases were received radical resection, 86 （21.7%） cases were received palliatve resection, 56（14.6%） cases were received exploratory operation or supportive treatment, 41 （20.7%） cases were received adjuvant hepatic arterial infusion, and 78（19.7%） cases were received adjuvant systemic chemotherapy. Survival statuses of the patients in different group were compared. [Results] The median survival time of radical resection group was significantly longer than those of palliative resection group, exploratory operation or supportive treatment group, adjuvant hepatic arteral infusion group, and adjuvant systemic chemotherapy group （37.1 months vs. 14.3, 6.3, 21.3, and 18.7 months, P 〈0.01）. The 5-year survival rates of the 5 groups were 31.2%, 0, 0, 7.5%, and 0, respectively. [Conclusions] Radical resection could improve survival of the patients with liver metastasis from colorectal cancer. Palliative resection has no advantage over adjuvant therapy. Adjuvant hepatic arterial infusion adjuvant systemic chemotherapy should be applied in the unresectable cases.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第11期1356-1358,共3页
China Journal of Modern Medicine
关键词
结、直肠癌肝肿瘤生存率
colorectal cancer
liver neoplasm
survival rate
