目的观察结直肠癌肝转移（colorectal cancer with liver metastasis,CRCLM）患者行根治性切除的疗效,分析影响术后肝转移瘤复发的危险因素。方法回顾性分析我院1993-2013年收治的行根治性切除术的结直肠癌肝转移患者164例资料,绘制其...目的观察结直肠癌肝转移（colorectal cancer with liver metastasis,CRCLM）患者行根治性切除的疗效,分析影响术后肝转移瘤复发的危险因素。方法回顾性分析我院1993-2013年收治的行根治性切除术的结直肠癌肝转移患者164例资料,绘制其术后远期生存率及无瘤生存率曲线。对影响术后肝转移瘤复发的因素分别进行单因素分析和多因素分析。结果术后第1、2、3、5年生存率分别为90.9%、72.1%、57.1%和26.0%,中位生存期为32（1~162）个月;术后第1、2、3、5年无瘤生存率分别为49.4%、38.4%、25.0%和14.0%,中位无瘤生存时间为12个月。术后并发症发生率为16.5%,术后30 d死亡率为1.2%。术后肝转移瘤复发率为46.3%,其中,边缘复发5例（6.6%）,同一肝段复发7例（9.2%）,邻近肝段复发7例（9.2%）,远隔肝段复发13例（17.1%）,多发肝段复发44例（57.9%）。各复发类型相比差异无统计学意义（P=0.062）。单因素分析显示原发瘤分化程度（P=0.035）、癌胚抗原（carcino-embryonic antigen,CEA）（P=0.013）、原发瘤区域淋巴结转移（P=0.043）和肝转移瘤切缘（P=0.012）与术后肝转移瘤复发相关;多因素分析显示原发瘤分化程度（P=0.021）和CEA（P=0.015）为影响术后肝转移瘤复发的独立危险因素。结论结直肠癌肝转移根治性切除术后远期生存率高,原发瘤分化程度和术前血浆CEA水平为影响术后肝转移瘤复发的独立危险因素。展开更多
Ninety patients with benign hepatic tumours,including fifty-four. hepatic cysts (A group)and thirty-six cavernous hemangiornas (B group),underwent surgical management in our departmentfrom Jan. 1963 to Oct. 1993. The ...Ninety patients with benign hepatic tumours,including fifty-four. hepatic cysts (A group)and thirty-six cavernous hemangiornas (B group),underwent surgical management in our departmentfrom Jan. 1963 to Oct. 1993. The patients were34 men and 56 women With mean age 49 years.The tumours were from 2 to 26 cm (mean,7.96 cm)in diameter. We performed regular or irregularhepatic lobectomies for 23 cases, hepatic segm-entectomies for 4, resection of tumours for 13,ligation of hepatic artery for 3,hepatic arterialembolization for 2,extirpation of single tumourfor 6, percutaneous transhepatic injection ofethanol for 4, internal drainage of the cystfor 5 and "unroof" operation for 30. Because itis difficult to distinguish between benign andmalignant tumour of the liver for a great partof the patients, further diagnostic approachshave to be considered, such as fusion ofMR, CT, Tc-99m-labeled red blood cellSPECTimage and tumours biopsy. The hepaticcavernous angiomas which was less than 8 cm indiameter and located at liver parenchyma canbe dynamically observed under follow up andthose more than 8 cm should be surgically removed.The extirpation of single tumour is the firstchoice of the surgical procedures for the tumourwas less than 10 cm in diameter. The "unroof"operation can be done if the diameter of hepatic cyst was more than 5 cm. Percutaneoustranshepatic injection of ethanol was recentlyused to treat cyst which the diameter was lessthan 10 cm within parenchyma of the liver.展开更多
文摘目的观察结直肠癌肝转移（colorectal cancer with liver metastasis,CRCLM）患者行根治性切除的疗效,分析影响术后肝转移瘤复发的危险因素。方法回顾性分析我院1993-2013年收治的行根治性切除术的结直肠癌肝转移患者164例资料,绘制其术后远期生存率及无瘤生存率曲线。对影响术后肝转移瘤复发的因素分别进行单因素分析和多因素分析。结果术后第1、2、3、5年生存率分别为90.9%、72.1%、57.1%和26.0%,中位生存期为32（1~162）个月;术后第1、2、3、5年无瘤生存率分别为49.4%、38.4%、25.0%和14.0%,中位无瘤生存时间为12个月。术后并发症发生率为16.5%,术后30 d死亡率为1.2%。术后肝转移瘤复发率为46.3%,其中,边缘复发5例（6.6%）,同一肝段复发7例（9.2%）,邻近肝段复发7例（9.2%）,远隔肝段复发13例（17.1%）,多发肝段复发44例（57.9%）。各复发类型相比差异无统计学意义（P=0.062）。单因素分析显示原发瘤分化程度（P=0.035）、癌胚抗原（carcino-embryonic antigen,CEA）（P=0.013）、原发瘤区域淋巴结转移（P=0.043）和肝转移瘤切缘（P=0.012）与术后肝转移瘤复发相关;多因素分析显示原发瘤分化程度（P=0.021）和CEA（P=0.015）为影响术后肝转移瘤复发的独立危险因素。结论结直肠癌肝转移根治性切除术后远期生存率高,原发瘤分化程度和术前血浆CEA水平为影响术后肝转移瘤复发的独立危险因素。
文摘Ninety patients with benign hepatic tumours,including fifty-four. hepatic cysts (A group)and thirty-six cavernous hemangiornas (B group),underwent surgical management in our departmentfrom Jan. 1963 to Oct. 1993. The patients were34 men and 56 women With mean age 49 years.The tumours were from 2 to 26 cm (mean,7.96 cm)in diameter. We performed regular or irregularhepatic lobectomies for 23 cases, hepatic segm-entectomies for 4, resection of tumours for 13,ligation of hepatic artery for 3,hepatic arterialembolization for 2,extirpation of single tumourfor 6, percutaneous transhepatic injection ofethanol for 4, internal drainage of the cystfor 5 and "unroof" operation for 30. Because itis difficult to distinguish between benign andmalignant tumour of the liver for a great partof the patients, further diagnostic approachshave to be considered, such as fusion ofMR, CT, Tc-99m-labeled red blood cellSPECTimage and tumours biopsy. The hepaticcavernous angiomas which was less than 8 cm indiameter and located at liver parenchyma canbe dynamically observed under follow up andthose more than 8 cm should be surgically removed.The extirpation of single tumour is the firstchoice of the surgical procedures for the tumourwas less than 10 cm in diameter. The "unroof"operation can be done if the diameter of hepatic cyst was more than 5 cm. Percutaneoustranshepatic injection of ethanol was recentlyused to treat cyst which the diameter was lessthan 10 cm within parenchyma of the liver.
