结直肠癌同时性肝转移的手术疗效分析

Analysis of the result of resection of colorectal cancer with synchronous liver metastasis

目的探讨结直肠癌同时性肝转移的外科治疗临床价值和疗效。方法自2003年5月至2008年10月,对32例结直肠癌同时性肝转移患者行同期切除术为治疗组,同期内未行手术切除的肝转移瘤27例患者为对照组。两组术后以XELOX方案化疗。结果治疗组1、3和5年累积生存率为92.5%、53.1%、34.6%。对照组1、3和5年生存率为66.7%、18.5%、0。两组总生存率比较有统计学意义(P<0.05)。两组临床资料相比较无统计学意义(P>0.05)。治疗组中有6例患者术后发生胸腔积液,1例膈下积液,3例胆漏,无手术死亡病例。结论结直肠癌肝转移的的根治性切除是患者获得长期生存的有效治疗手段;直肠癌同时性肝转移行同期切除术可提高患者的生存时间和生存质量,改善其预后。

Objective To explore the clinical value and effects on the resection of eoloreetal cancer with synchronous liver metastasis. Methods From May 2003 to October 2008,32 patients who received hepatectomy and primary colorectal resection simultaneously were defined as the therapeutic group. 27 patients who didn＇t received resection of liver metastases from eolorectal cancer were defimed as the control group. The regimen of XELOX was used in both groups postoperatively. Results The 1-,3- and 5-year cumulative survival rates in the therapeutic group were 92.5%,53.1%,34.6%. The 1-,3- and 5-year cumulative survival rates in the control group were 66.7%,18.5%,0. Sigrfifieant differences were found in overall response rate between the therapeutic group and the control group（P〈 0.05）. No significant differences were found in chnical data between the two groups （P〉0.05）. In the therapeutic group, hydrothorax was in 6 patients, subdiaphragmatic hydropsy in 1 patient, biliary leakage in 3 patients. No serious complications such as death occurred. Conclusion Radical resection of hepatic metastases from colorectal cancer is considered the only effective therapy for long-term survival. Resection of colorectal cancer with synchronous liver metastasis can improve the long-term survival, quality of life and their prognosis.