摘要
目的探讨结直肠癌肝转移的外科手术适应证和疗效,以及临床病理因素对其预后的影响。方法回顾性分析1991年1月至2000年12月间施行肝切除术的61例结直肠癌肝转移患者的临床资料。结果结直肠癌肝转移切除术后1、3、5年生存率分别为72.1%、58.1%和26.0%,术后出现并发症8例,20例肝转移灶有假包膜形成。结直肠癌Dukes分期、病理类型、转移灶数目、假包膜形成对术后生存率有影响(P<0.05)。术后综合治疗者3年生存率明显优于无综合治疗者(P<0.05)。肝转移灶大小及其切除时间并不影响患者预后(P>0.05)。结论临床病理分期早、肿瘤分化程度高、转移灶数目不超过3个、肿瘤假包膜形成及术后综合治疗预示结直肠癌肝转移切除患者有较好的预后。
Objective To explore the indications and effect of surgical resection for hepatic matastases from colorectal adenocarcinoma and to discuss the implications of clinicopathologic features on the prognosis. Methods A retrospective study of 61 patients undergoing hepatectomy for metastatic tumors from colorectal ad from January 1991 to December 2000 in our hospital was performed retrospectively. Results The 1-, 3- and 5-year survival rates after hepatic resection were 72. 13% , 58. 10% and 26. 01% respectively. Complications occurd in 8 cases. Tumor pesudomembrance was found in 20 cases. Dukes stage, pathologic type, the number of hepatic metastases and tumor pesudomembrance were all significant factors for prognosis after surgery（ P 〈 0. 05） . The 3-year survival rate of the patients with postoperative comprehensive treatment was higher than that with non-postoperative treatment（ P 〈 0.05）. The size of hepatic metastases and the resecting time didn＇t affect the prognosis （ P 〉 0. 05 ）. Conclusion The hepatic metastases from colorectal cancer should be treated by a surgical approach. The earlier stage of clinical pathology, higher differentiation extent, metastases less than 3, the formation of pesudomembrance of the metastatic tumor and the postoperative comprehensive treatment predict a better survival.
出处
《中华胃肠外科杂志》
CAS
2005年第5期440-442,共3页
Chinese Journal of Gastrointestinal Surgery
