大肠癌伴肝转移的治疗及预后因素分析:附52例报告

Analysis of the treatment and prognostic factors of hepatic metastases of colorectal cancer:a report of 52 cases

目的 探讨大肠癌肝转移手术切除的疗效及影响术后生存率的因素,以改进提高远期疗效的措施。方法 对 5 2例手术治疗的大肠癌肝转移患者进行随访,比较 1 1例生存 5年以上与 4 1例生存 5年以内的患者的临床病理资料。结果 全组术后 1, 3, 5年生存率分别为 7 5% , 3 0. 8%和2 1. 2%。影响患者愈后的因素主要有:原发癌病理类型、肝转移病灶数目、手术方式及时机选择,术后治疗 (均P< 0. 0 5 )。结论 根治切除以及加强术后综合治疗是提高远期疗效的关键。

Objective To evaluate the therapeutic effect,prognostic factors and the methods to improve long term survival of liver resection for hepatic metastases of colorectal cancer.Methods 52 patients operated on for hepatic metastases from colorectal cancer were followed up,and the clinical and pathologic data of 11 (cases),who survived more than 5 years,were compared with 41 survivors of less than 5 years after hepatic (resection).Results The 1-,3-and 5-year survival rate was 75.0%,30.8%,and 21.2%,(respectively).The important factors affecting prognosis were pathologic type of the primary cancer,(number) of (hepatic) metastasis,selection of the methods and timing of surgery,and postoperative treatment(P<(0.05)).Conclusions The cruxes to improve long-term therapeutic results are radical resection and intensive (postoperative) combined therapy.