CAJ | 학술논문

目的探讨手术治疗乳腺癌肝转移的疗效及预后影响因素.方法回顾性收集2000-2009年在我院就诊的47例乳腺癌术后肝转移手术治疗资料和随访结果,分析乳腺癌肝转移患者的临床特征及其与预后的关系.结果本组患者围手术期死亡率为0,术后1、3、5年累积生存率分别为74.5％、42.5％和17.0％,中位生存时间为29个月.其中肝内转移灶数目＜3个者平均生存时间为79.4个月,1、3、5年累积生存率分别为86.7％、53.3％和23.3％；肝内转移灶数目≥3个者平均生存时间为34.6个月,1、3、5年累积生存率分别为52.8％、23.5％和5.9％,两组间差异有统计学意义(P=0.001).伴有肝脏周围局部淋巴结转移者平均生存时间为28.6个月,1、3、5年累积生存率分别为53.8％、23.1％和0；无局部淋巴结转移者平均生存时间为71.9个月,1、3、5年累积生存率分别为82.3％、50.0％和23.5％,两组间差异亦有显著统计学意义(P＝0.002).患者生存率和生存时间与转移瘤分化程度以及雌激素受体(ER)、孕酮受体(PR)、Her-2受体阳性与否无关.结论乳腺癌术后肝转移患者,手术治疗安全性好.与转移灶数目≥3者相比,转移灶数目＜3个者可取得更好的远期疗效；局部淋巴结转移者预后要比无转移者差.
목적 탐토수술치료유선암간전이적료효급예후영향인소.방법 회고성수집2000-2009년재아원취진적47례유선암술후간전이수술치료자료화수방결과,분석유선암간전이환자적림상특정급기여예후적관계.결과 본조환자위수술기사망솔위0,술후1、3、5년루적생존솔분별위74.5％、42.5％화17.0％,중위생존시간위29개월.기중간내전이조수목＜3개자평균생존시간위79.4개월,1、3、5년루적생존솔분별위86.7％、53.3％화23.3％；간내전이조수목≥3개자평균생존시간위34.6개월,1、3、5년루적생존솔분별위52.8％、23.5％화5.9％,량조간차이유통계학의의(P=0.001).반유간장주위국부림파결전이자평균생존시간위28.6개월,1、3、5년루적생존솔분별위53.8％、23.1％화0；무국부림파결전이자평균생존시간위71.9개월,1、3、5년루적생존솔분별위82.3％、50.0％화23.5％,량조간차이역유현저통계학의의(P＝0.002).환자생존솔화생존시간여전이류분화정도이급자격소수체(ER)、잉동수체(PR)、Her-2수체양성여부무관.결론 유선암술후간전이환자,수술치료안전성호.여전이조수목≥3자상비,전이조수목＜3개자가취득경호적원기료효；국부림파결전이자예후요비무전이자차.
Objective To study the outcomes of partial hepatectomy in patients with liver metastases from breast cancer.Methods The data of 47 patients who underwent partial hepatectomy for liver metastases from breast cancer between 2000 and 2009 were studied.The relationship between the clinical features and outcomes were analyzed retrospectively.Results The mortality of surgery was 0％.The 1-,3-,and 5-year survival rates for these 47 patients were 74.5％,42.5％ and 17.0％ respectively.The median survival was 29 months.Patients with less than 3 metastatic nodules survived longer than those with more than 3 metastatic nodules.The 1-,3-,and 5-year survival rates were 86.7％,53.3％,23.3 ％ versus 52.8％,23.5％,5.9 ％,and the mean survival was 79.4 months versus 34.6 months (P=0.001),respectively.Patients without local lymph node metastases had longer survival than those with local lymph nodes metastases.The 1-,3-,and 5-year survival rates were 82.3％,50.0％,23.5％ versus 53.8％,23.1 ％,0％,and the mean survival was 71.9 mouths versus 28.6 months (P＝0.002),respectively.There was no relationship between survival and tumor differ entiation,expression of ER,PR and Her 2.Conclusion Surgical treatment was safe for patients with liver metastases from breast cancer.The long-term survival was better for patients with liver metastases with less than 3 nodules compared to those with more than 3 nodules.The survival was poorer in patients with local lymph node metastases than those without lymph node metastases.