转移性肝癌外科治疗及预后因素分析

PROGNOSIS IN PATIENTS WITH METASTATIC LIVER CANCER

目的 为探讨转移性肝癌肝切除术疗效及影响预后因素 ,对 78例转移性肝癌肝切除术进行回顾性分析。方法 我院从1982年 1月到 1994年 1月对 78例肝转移癌的病人 ,在原发癌根治术的基础上行肝切除术。其中 48例原发癌为结直肠癌 ,30例为非结直肠癌。随访生存时间并分析影响预后诸因素。结果 转移性肝癌切除术后总的 1、3、5年生存率分别为 76 .91%、39.6 %、2 5 .6 4%。肝转移癌灶数目超过 2个的病人 5年生存率为 0 % ,而转移灶少于 2个的为 37.3%差异显著 (P<0 .0 1)。合并肝外有淋巴结转移的 5年生存率差 (0 % ) ,而无肝外淋巴结转移的 5年生存率佳 (2 8.98% ) (P<0 .0 1)。结论 对肝转移癌的病人应将原发癌继发癌均切除 ,其预后和肝转移病灶数目 ,肝外淋巴结转移情况以及治疗方式密切相关。

Objective To explore the therapeutic effect of surgical resection on patients with metastatic liver cancer.We conducted a retrospective analysis for 78 cases with resection of metastatic liver cancer.Metheds From Jan.1982 to Jan.1994,78 cases with metastatic liver cancer received hepatectomy in our hospital.All patients had their primary cancer resected.Among them,48 cases were colorectal cancer and 30 cases were noncolorectal cancer.The survival time were followed up and factors affecting the prognosis were analysed.Results The 1、3、5 year survival rates are 76.91%,39.61% and 25.64% after the hepatectomy respectively.The 5 year survival rates of patient with multiple metastatic cancer nodule was poor(0%),there is apparent difference(P<0.01)compared with that of cases with multiple metastatic cancer nodule two or less than two(37.3%).The 5 year survival rates of the patients with extro-hepatic lymph node involvment was poor too(0%),there is apparent difference(P<0.01)compared with that in patients without extrohepatic lymph node involvment(28.98%).Conclusion To the patients with liver metastases,their primary cancer should be resected and combined their secondary cancer resection.The prognosis of liver metastases is closely interrelated to treatment method,number of metastatic cancer-foci and extrohepatic lymph node involvment.