结直肠癌同时性肝转移治疗46例分析

目的:探讨结直肠癌同时性肝转移的有效治疗方法。方法:对1996～2004年收治的46例结直肠癌同时性肝转移的临床资料和随访资料进行回顾性分析。根据治疗方法的不同分为3组:A组21例,为一期切除原发灶和肝转移灶并经肝动脉和门静脉置泵化疗者;B组15例,为单纯原发灶切除并经肝动脉和门静脉置泵化疗者;C组10例,为原发灶和肝转移灶均未能切除而仅行肝动脉和门静脉置泵化疗者。用KaplanMeier法对病人的生存时间作统计分析。结果:A、B、C3组术后中位生存期分别为38、20和13个月;各组之间术后生存时间的比较均有显著统计学差异(P<0.01)。结论:结直肠癌原发灶和肝转移灶一期手术切除并经肝动脉和门静脉置泵化疗的疗效最好;肝转移灶无法切除者能将原发灶切除并经肝动脉和门静脉置泵化疗也可取得较好的疗效;原发灶和肝转移灶未能切除而仅经肝动脉和门静脉置泵化疗的疗效相对较差。对结直肠癌同时性肝转移应采取以手术切除为主的综合措施进行积极治疗。

Analysis of the Treatment for Colorectal Cancer with Synchronous Liver Metastasis in 46 Cases

Objective:To explore the effective treatment for colorectal cancer with synchronous liver metastasis. Methods:The follow-up and clinical data of 46 patients with colorectal cancer with synchronous liver metastasis were analyzed retrospectively. The patients were divided into 3 groups: Group A: 21 cases were received one stage resection for primary lesion and liver metastasis plus chemotherapy through hepatic artery and portal vein transfusion pump; Group B: 15 cases were received simple resection for primary lesion plus chemotherapy through hepatic artery and portal vein transfusion pump; Group C: 10 cases, whose primary lesion and liver metastasis could not be resected, were received laparotomy plus chemotherapy through hepatic artery and portal vein transfusion pump. The survival time was analyzed by Kaplan-Meier method.Results:The median survival time of group A, B and C were 38, 20 and 13 months respectively. There were significant differences in survival time among these three groups (P<0.01). Conclusion:Colorectal cancer with synchronous liver metastasis should be positively treated by synthetic methods including surgical resection and chemotherapy.