摘要
目的探讨结直肠癌同时性肝转移和腹膜扩散患者的相关临床病理因素以及手术干预对其预后的影响。方法回顾性分析12年间中山大学附属第一医院肠癌数据库资料中有同时性肝转移和/或腹膜扩散患者(166例/150例)的临床病例资料及随访结果。结果在诸多病理因素中肿瘤分化程度和浆膜浸润与腹膜扩散有关(P<0.01),而肿瘤分化程度,浆膜浸润和Ducks分期等与同时性肝转移有关(P<0.01);手术不可切除的结直肠癌伴同时性肝转移组与伴腹膜扩散组的短期和长期生存率差异无统计学意义(P>0.05),而在手术可切除组中伴腹膜扩散者的长期生存率优于伴肝转移者(P<0.01)。结论结直肠癌腹膜转移患者较同时性肝转移患者长期预后好;手术不可切除的结直肠癌伴腹膜扩散或肝转移才标示着肿瘤的终末期;结直肠癌伴腹膜转移根治切除组较伴同时性肝转移根治切除组预后好,局限的结直肠癌伴腹膜转移通过手术可能得到根治。
Objective To investigate the correlation of pathologic factors with the prognosis of colorectal cancer patients with peritoneal dissemination and/or synchronous liver metastasis, and the effect of surgical intervention on the prognosis. Methods Based on our 12-year database, the clinieopathologic data and the result of follow-up of coloreetal cancer complicated with peritoneal dissemination （150 cases） and/or synchronous liver metastasis （166 cases） were analyzed retrospectively. Results Multi-variatc analysis indicated that peritoneal dissemination from colorectal cancer was associated with the depth of tumor infiltration and tumor differentiation, while liver metastasis was associated with tumor differentiation, depth of tumor infiltration and the Dukes staging（P〈0.01）. Both short-term and long-term overall survival rates showed no statistical difference between unresectable eolorectal cancer patients with peritoneal dissemination and unreseetable colorectal cancer patients with liver metastasis （P〉0.05）. However, in the resectable colorectal cancer patients, long-term overall survival of the patients with peritoneal dissemination was significantly better than those with liver metastasis （P〈0.01）. Conclusions Patients with peritoneal dissemination have better long term prognosis than those with liver metastasis in colorectal cancer. Only the unresectable peritoneal dissemination or liver metastasis is indicative of end-stage colorectal cancer. Radical resection of colorectal cancer with peritoneal dissemination has a better prognosis than radical resection for patients with synchronous liver metastasis. Radical excision could be achieved in patients with local peritoneal dissemination.
出处
《中国普通外科杂志》
CAS
CSCD
2008年第10期950-954,共5页
China Journal of General Surgery
关键词
结直肠肿瘤/外科学
肝肿瘤/继发性
腹膜扩散
肿瘤转移
预后
Coloreetal Neoplasms/surg
Liver Neoplasms /second
Peritoneal Dissemination
Neoplasm Metastasis
Prognosis
