结直肠癌肝转移不同治疗方式的预后比较

Prognosis of Different Treatments for Colorectal Liver Metastases

目的探讨不同治疗方式对结直肠癌肝转移生存时间和无复发生存时间的影响。方法回顾性分析2002年1月至2013年5月期间解放军总医院收治的71例结直肠癌肝转移患者的临床资料,分析干预对结直肠癌肝转移患者生存时间和无复发生存时间的影响。结果 71例结直肠癌肝转移患者的原发灶均行根治性切除。对肝转移灶,20例未予干预(未干预组);20例行肝转移灶切除,20例行射频消融,11例行肝转移灶切除+射频消融(所有接受干预的患者为干预组)。Cox比例风险模型结果显示,在控制其他因素的情况下,干预对生存(HR=1.724,P=0.043)和无复发生存(HR=0.701,P=0.048)均有影响,接受干预患者的生存情况和无复发生存情况较好。结论在对结直肠癌行根治性手术的条件下,对结直肠癌肝转移灶给予干预措施可以延长结直肠癌肝转移患者的生存时间和无复发生存时间。

Objective To analyze the influence of different surgical methods on survival and relapse-free survival in colorectal liver metastases. Methods Clinical data of 71 cases of colorectal liver metastases who treated in PLA General Hospital from January 2002 to May 2013 were collected retrospectively, to analyzed the effect of different surgical methods on survival and relapse-free survival of this kind of cases. Results All of primary lesions underwent radical resection. And for the liver metastases, 20 cases didn’t received any intervention（non-intervention group）, 20 cases underwent resection of liver metastases, 20 cases underwent radiofrequency ablation, and 11 cases underwent radiofrequency ablation and resection of liver metastases（all 61 cases who received intervention were classified to intervention group）. Results of Cox proportional hazards model showed that, in the condition of controlling other confounding factors, intervention can improve the survival（HR=1.724, P=0.043） and relapse-free survival（HR=0.701, P=0.048） of cases of colorectal liver metastases, cases who received intervention had better survival situation and the relapse-free survival situation. Conclusion For cases of colorectal liver metastases, in condition of radical operation for colorectal cancer, the intervention for liver metastases can prolong the survival time and relapse-free survival time.