48例结直肠癌肝转移的外科疗效

Surgical efficacy of 48 cases of colorectal cancer with liver metastasis

目的探讨结直肠癌肝转移外科手术治疗的疗效和影响术后生存率的有关因素,总结提高远期疗效的措施。方法将48例结直肠癌肝转移手术患者作为观察组,其中根治性切除35例,非根治性切除13例;取同期34例结直肠癌肝转移患者作为对照组。对两组的临床资料进行回顾分析,评价转移灶的大小、数目、范围、间隔时间(无瘤期)和术式及术后综合治疗等因素对疗效的影响。结果观察组术后1、3、5年生存率分别为91.7%、50.0%、29.2%,对照组1、3、5年生存率分别为29.4%、17.6%、0%,两组间对比差异有统计学意义(P<0.05);根治性切除与非根治性切除的5年生存率分别为48.6%、15.4%,两种术式对比差异有统计学意义(P<0.05);术后综合治疗与单一或未治疗的5年生存率分别为40.63%,6.25%,两两对比差异有统计学意义(P<0.05);肝转移癌单结节与多结节的5年生存率分别为48.4%、15.4%,两两对比差异有统计学意义(P<0.05);原发癌与转移癌间的无瘤期2年以内与2年以上的5年生存率分别为11.5%、71.4%,两两对比差异有统计学意义(P<0.05)。结论手术切除结直肠癌肝转移灶可提高疗效,早发现是提高治愈性切除率的关键。采用以手术为主的综合治疗可提高远期疗效,癌灶数目、大小、无瘤期、术式及术后综合治疗等是影响远期疗效的重要因素。

Objective To probe the curative effect of surgical treatment on colorectal cancer with liver metastasis,the factors that affect postoperative survival rate,and the measures for improving long-term curative effect.Methods Clinical data from 48 cases of colorectal cancer with liver metastasis were analyzed retrospectively,among which 35 cases were treated with radical excision and 13 cases were with non-radical excision.Results 1-,3-and 5-year postoperative survival rates were 91.7%,50.0% and 29.2% respectively.The number of tumor,operation method and postoperative therapy were the important factors for influencing long-term curative effect.Conclusions Early detection and early excision of the metastatic liver cancer is the key to improve healing rate.Comprehensive therapy after operation can improve the long-term curative effect of colorectal cancer with liver metastasis.