CAJ | 학술논문

目的：探讨影响结直肠癌同时性肝转移患者术后预后的临床病理因素。方法76例结直肠癌同时性肝转移患者行结直肠癌切除，并同期行肝转移瘤切除，统计患者术后生存时间，先后应用log-rank检验及Cox模型分析可能影响预后的有关临床病理因素。结果患者术后生存期8～109个月，中位生存期38个月，3年生存率56.58％，5年生存率35.53％。应用log-rank生存分析筛选与患者预后有关的临床病理因素，原发瘤的T分期、N分期、分化程度、术前CEA水平、肝转移灶大小、数量与患者预后相关。多因素分析显示，术前CEA水平、肝转移瘤的大小及肝转移灶数量是影响结直肠癌同时性肝转移患者术后预后的重要因素。结论对于可同期切除的直肠癌同时性肝转移的患者应积极手术治疗，以提高患者的生存率。患者肝转移瘤的数量、大小与术前CEA水平与预后密切相关。
목적：탐토영향결직장암동시성간전이환자술후예후적림상병리인소。방법76례결직장암동시성간전이환자행결직장암절제，병동기행간전이류절제，통계환자술후생존시간，선후응용log-rank검험급Cox모형분석가능영향예후적유관림상병리인소。결과환자술후생존기8～109개월，중위생존기38개월，3년생존솔56.58％，5년생존솔35.53％。응용log-rank생존분석사선여환자예후유관적림상병리인소，원발류적T분기、N분기、분화정도、술전CEA수평、간전이조대소、수량여환자예후상관。다인소분석현시，술전CEA수평、간전이류적대소급간전이조수량시영향결직장암동시성간전이환자술후예후적중요인소。결론대우가동기절제적직장암동시성간전이적환자응적겁수술치료，이제고환자적생존솔。환자간전이류적수량、대소여술전CEA수평여예후밀절상관。
Objective To analyze the prognostic factors of patients with colorectal cancer ( CRC) with synchro-nous liver metastasis after operation .Methods CRC resection and simultaneous resection of liver metastases were per-formed in 76 cases of CRC with synchronous liver metastasis .The survival was analyzed .The suspected prognostic factors were analyzed by log-rank method and Cox model .Results The median survival was 38 months after operation (8 to 109 months ) , with three year survival of 56.58%and five year survival of 35.53%.Log-rank test indicated that significant prognostic factors were primary tumor T staging , N staging, histologic differentiated grade , preoperative CEA level , and the size and the number of liver metastases .Furthermore, multivariate analysis showed that preoperative CEA level , and the size and number of liver metastasis were the most important prognostic factors .Conclusion Simultaneous resection of CRC and liver metastasis is necessary for patients with CRC with synchronous liver metastasis .The size and the number of liver metastases , and the preoperative CEA level are closely related with the prognosis .