中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2009年
4期
337-341
,共5页
任黎%吕世旭%钟芸诗%许剑民%韦烨%樊嘉%钦伦秀%王建华%程洁敏%钱晟%秦新裕
任黎%呂世旭%鐘蕓詩%許劍民%韋燁%樊嘉%欽倫秀%王建華%程潔敏%錢晟%秦新裕
임려%려세욱%종예시%허검민%위엽%번가%흠륜수%왕건화%정길민%전성%진신유
结直肠肿瘤%肿瘤转移%肝%肝切除术%预后
結直腸腫瘤%腫瘤轉移%肝%肝切除術%預後
결직장종류%종류전이%간%간절제술%예후
Colorectal neoplasms%Neoplasm metastasis,liver%Hepatectomy%Prognosis
目的 评价结直肠癌肝转移不同类型及治疗策略对肝转移患者生存的影响.方法 回顾分析复旦大学附属中山医院2000年1月1日至2008年6月31日收治的669例结直肠癌肝转移患者的病例资料.结果 本组患者同时性肝转移379例,异时性[发生肝转移中位时间(21.0±19.6)个月]肝转移290例.患者性别、年龄和肠道原发病灶的部位两组差异无统计学意义(P>0.05);而肝转移灶特征(累及肝叶类型、病灶个数和病灶直径)和术前CEA、CA19-9水平两组差异有统计学意义(P<0.05).手术切除肝转移灶253例,其中同时性肝转移123例,异时性肝转移130例.以2008年10月31日为随访终点,随访率100%.同时性肝转移和异时性肝转移的中位生存时间分别为11和23个月(P<0.01).5年生存率分别为6.4%和11.4%(P<0.01):手术病例与各种非手术治疗(介入、化疗、射频、无水酒精注射和中医中药)病例的中位生存期分别为37个月和5～26个月(P<0.01);5年生存率分别为35.6%和0～3.6%(P<0.05).结论 手术治疗目前仍是结直肠癌肝转移的首选治疗措施;异时性肝转移患者生存率好于同时性肝转移.
目的 評價結直腸癌肝轉移不同類型及治療策略對肝轉移患者生存的影響.方法 迴顧分析複旦大學附屬中山醫院2000年1月1日至2008年6月31日收治的669例結直腸癌肝轉移患者的病例資料.結果 本組患者同時性肝轉移379例,異時性[髮生肝轉移中位時間(21.0±19.6)箇月]肝轉移290例.患者性彆、年齡和腸道原髮病竈的部位兩組差異無統計學意義(P>0.05);而肝轉移竈特徵(纍及肝葉類型、病竈箇數和病竈直徑)和術前CEA、CA19-9水平兩組差異有統計學意義(P<0.05).手術切除肝轉移竈253例,其中同時性肝轉移123例,異時性肝轉移130例.以2008年10月31日為隨訪終點,隨訪率100%.同時性肝轉移和異時性肝轉移的中位生存時間分彆為11和23箇月(P<0.01).5年生存率分彆為6.4%和11.4%(P<0.01):手術病例與各種非手術治療(介入、化療、射頻、無水酒精註射和中醫中藥)病例的中位生存期分彆為37箇月和5～26箇月(P<0.01);5年生存率分彆為35.6%和0～3.6%(P<0.05).結論 手術治療目前仍是結直腸癌肝轉移的首選治療措施;異時性肝轉移患者生存率好于同時性肝轉移.
목적 평개결직장암간전이불동류형급치료책략대간전이환자생존적영향.방법 회고분석복단대학부속중산의원2000년1월1일지2008년6월31일수치적669례결직장암간전이환자적병례자료.결과 본조환자동시성간전이379례,이시성[발생간전이중위시간(21.0±19.6)개월]간전이290례.환자성별、년령화장도원발병조적부위량조차이무통계학의의(P>0.05);이간전이조특정(루급간협류형、병조개수화병조직경)화술전CEA、CA19-9수평량조차이유통계학의의(P<0.05).수술절제간전이조253례,기중동시성간전이123례,이시성간전이130례.이2008년10월31일위수방종점,수방솔100%.동시성간전이화이시성간전이적중위생존시간분별위11화23개월(P<0.01).5년생존솔분별위6.4%화11.4%(P<0.01):수술병례여각충비수술치료(개입、화료、사빈、무수주정주사화중의중약)병례적중위생존기분별위37개월화5～26개월(P<0.01);5년생존솔분별위35.6%화0～3.6%(P<0.05).결론 수술치료목전잉시결직장암간전이적수선치료조시;이시성간전이환자생존솔호우동시성간전이.
Objective To evaluate the relation between different therapy and survival rate of liver metastasis of eoloreetal cancer (LMCC). Methods Clinical data of 669 LMCC patients, collected from Fudan University Zliongshan Hospital from January 2000 to July 2008, were analyzed retrospectively.Results Of the 669 eases, 379 eases were synchronous liver metastases (SLM) and 290 cases were metachronous liver metastases (MLM). There were no significant differeneos in age, gender and position of primary tumor between SLM and MLM groups (P>0.05), but as to liver metastasis charaeteristics (liver lobe involved, focus number and maximal focus diameter) and CEA, CA19-9 before therapy,there were significant differences (P<0.05). Two hundred and fifty-three eases underwent curative hepatic resection, including 123 cases in SLM and 130 eases in MLM. Until October 31, 2008, all the cases were followedup. The median survival time of SLM was (11 ± 1) months and of MLM (23+2) months (P<0.01). Five-year survival rate of SLM was 6.4% and of MLM 11.4%(P<0.01). As to different treatments, median survival time and 5-year survival rate of curative hepatic resection group were 37months and 35.6%, and of non-operation groups (i.e. intervention, chemotherapy, radiofrequeney therapy and percutaneous ethanol injection) were 5 to 26 months and 0 to 3.6% respectively (P<0.05).Conclusions Curative hepatic resection is the first choice of liver metastasis of colorectal cancer,which can improve the survival rate. Resection rate and survival of MLM are better than those of SLM.
