结直肠癌肺转移手术治疗疗效及预后影响因素的回顾性分析

Efficacy and prognostic analysis on surgical resection of pulmonary metastasis from colorectal cancer

目的:探讨结直肠癌肺转移患者手术切除肺转移灶的疗效及术后生存的影响因素。方法:回顾性分析79例结直肠癌肺转移灶切除患者的临床资料,统计分析其生存期及预后影响因素。结果:全组患者中位随访时间52.0个月。中位生存时间36.0个月,5年生存率为35.1%。29例患者死于肿瘤进展;27例生存患者中,18例带瘤生存,9例无瘤生存,其中1例至今已无瘤生存159个月。单因素分析结果显示,无瘤间期(DFI)时间的长短对肺转移瘤切除术后的生存有影响(P=0.036);而患者的性别、年龄、原发肿瘤部位、肺转移瘤大小和位置、手术方式、肺转移瘤手术前CEA水平及复发后再次行肺转移瘤切除均与其术后生存时间无关。结论:对于结直肠癌肺转移患者,手术是有潜在治愈可能的治疗方法。DFI可能与肺转移瘤切除术后生存有关。

OBJECTIVE： To detect the efficacy and probable prognostic factors of surgical resection of pulmonary metastasis from colorectal cancer. METHODS： Clinical data and outcomes of 79 colorectal patients with pulmonary metastasis undergone pulmonary metastasectomy were analyzed retrospectively. RESULTS： Median follow-up time was 52.0 months. The median overall survival time was 36.0 months. Five-year survival rate was 35.1%. Totally 29 patients died of tumor progression. Twenty-seven patients were surviv al including survival with tumor （18 cases） and without tumor （9 cases）. One patient was still alive without tumor for 159 months. Univariate analysis revealed that disease free interval（DFI） was a prognostic risk factor （P=0. 036）, while gender, age primary tumor site, pulmonary metastasis size and location, surgical procedure, pre-surgical CEA level,re-metastasectomy did not show influence on the survival time after pulmonary metastaseetomy. CONCLUSIONS： For some selected pa tients with indication, pulmonary metastasectomy may be a potential curative method. DFI may be associated with the prognosis after pulmonary metastasectomy.