中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2015年
6期
388-392
,共5页
闫晓峦%王崑%包全%孙谊%王宏伟%金克敏%邢宝才
閆曉巒%王崑%包全%孫誼%王宏偉%金剋敏%邢寶纔
염효만%왕곤%포전%손의%왕굉위%금극민%형보재
结直肠癌%肝转移%肝切除%临床评分系统%预后评价
結直腸癌%肝轉移%肝切除%臨床評分繫統%預後評價
결직장암%간전이%간절제%림상평분계통%예후평개
Colorectal cancer%Liver metastases%Hepatectomy%Clinic risk score%Prognostic evaluation
目的 探讨影响结直肠癌肝转移外科手术治疗预后的风险因素,验证现有风险评分的临床使用价值.方法 回顾性分析北京肿瘤医院肝胆胰外一科2000年1月至2014年8月行肝切除手术治疗的303例结直肠癌肝转移患者的临床资料及术后随访情况,进行生存状况分析.采用单因素和Cox比例风险回归模型等分析影响结直肠癌肝转移患者生存的相关因素,验证目前广泛应用的5种临床风险评分体系对患者生存预测的准确性.结果 全组患者1、3、5年总生存率分别为89.2％、50.8％、38.6％.中位生存期37个月.原发灶N分期和肝切除术前癌胚抗原(CEA)水平是影响预后的独立危险因素.MSKCC评分对患者术后总生存的预测效果最优(C-index:0.903).结论 结直肠癌肝转移患者术后生存受多种风险因素影响,现有的5种预后评分体系中MSKCC评分预测效果最优.
目的 探討影響結直腸癌肝轉移外科手術治療預後的風險因素,驗證現有風險評分的臨床使用價值.方法 迴顧性分析北京腫瘤醫院肝膽胰外一科2000年1月至2014年8月行肝切除手術治療的303例結直腸癌肝轉移患者的臨床資料及術後隨訪情況,進行生存狀況分析.採用單因素和Cox比例風險迴歸模型等分析影響結直腸癌肝轉移患者生存的相關因素,驗證目前廣汎應用的5種臨床風險評分體繫對患者生存預測的準確性.結果 全組患者1、3、5年總生存率分彆為89.2％、50.8％、38.6％.中位生存期37箇月.原髮竈N分期和肝切除術前癌胚抗原(CEA)水平是影響預後的獨立危險因素.MSKCC評分對患者術後總生存的預測效果最優(C-index:0.903).結論 結直腸癌肝轉移患者術後生存受多種風險因素影響,現有的5種預後評分體繫中MSKCC評分預測效果最優.
목적 탐토영향결직장암간전이외과수술치료예후적풍험인소,험증현유풍험평분적림상사용개치.방법 회고성분석북경종류의원간담이외일과2000년1월지2014년8월행간절제수술치료적303례결직장암간전이환자적림상자료급술후수방정황,진행생존상황분석.채용단인소화Cox비례풍험회귀모형등분석영향결직장암간전이환자생존적상관인소,험증목전엄범응용적5충림상풍험평분체계대환자생존예측적준학성.결과 전조환자1、3、5년총생존솔분별위89.2％、50.8％、38.6％.중위생존기37개월.원발조N분기화간절제술전암배항원(CEA)수평시영향예후적독립위험인소.MSKCC평분대환자술후총생존적예측효과최우(C-index:0.903).결론 결직장암간전이환자술후생존수다충풍험인소영향,현유적5충예후평분체계중MSKCC평분예측효과최우.
Objective To identify the risk factors associated with overall survival (OS) for patients undergoing partial hepatectomy for colorectal liver metastases,and to assess the predictive values of five published scoring systems in an independent patient cohort for the purpose of external validation.Methods The clinical,pathologic,and complete follow-up data were prospectively collected from 303 consecutive patients who underwent primary hepatic resection for colorectal liver metastases at the Beijing Cancer Hospital from January 2000 to Aug 2014.The predictive values of the Nordlinger score,the Memorial Sloan-Kettering Cancer Center (MSKCC) score,the Iwatsuki score,the Basingstoke index,and the Konopke scoring system were assessed in this patient set.The clinical and pathologic parameters were further analyzed using univariate and multivariate analyses.Results The 1-,3-and 5-year overall survival were 89.2％,50.8％ and 38.6％,respectively.The median survival time was 37 months.Two risk factors were found to be independent predictors of poor overall survival:the N stage of the primary tumor,and a carcinoembyonic antigen level ＞ 30 μg/L.The MSKCC score had the best independent predictive power for survival when compared with the other 4 prognostic systems (C-index:0.903).Conclusion In our patient cohort,the MSKCC score was the best staging system in predicting survival.
