大肠癌肝转移的治疗

目的 探讨大肠癌肝转移治疗的有效方法.方法 对大肠癌肝转移86例,在原发灶切除的基础上,分为转移灶单纯切除、栓塞化疗切除、单纯栓塞化疗和全身化疗四组进行治疗,并分析单发性肝转移癌、局限于一段或一叶的多发性转移癌、左右肝均有转移癌的不同疗效.结果 单纯切除组和栓塞化疗切除组的一年生存率,均优于单纯栓塞化疗组(P<0.05);而单纯栓塞化疗组的一年生存率又优于单纯化疗组(P<0.05).在手术切除的两组病例中,单发性转移癌术后一年生存率优于左右肝均有转移灶的术后生存率(P<0.01);而局限于肝脏一段或一叶的多发性转移癌,栓塞化疗切除组的三年生存率,优于单纯切除组(P

THERAPY FOR LIVER METASTASIS OF COLORECTAL CARCINOMAS

PURPOSE To explore an efficacious therapy for liver metastasis of colorectal carcinomas. METHODS Basing on excision of primary lesions. 86 cases of colorectal carcinomas metastasize to liver were treated in four different manners, namely: sole resection of the metastasis lesions, chemoembolization-resection, sole chemoembolization. and chemotherapy. We also analyze the efficacy in curing single metastatic liver cancer, multiple metastatic cancer that is confined to one section or both left and right sections of liver. RESULTS One year survival rates in the groups of sole resection and chemoembolization-resection are better than that of sole chemoembolization P<0. 05 whereas they were higher in sole chemoembolization than those of sole chemotherapy, P< 0. 05. In the two groups for surgical resection, the one year survival rate of single liver metastasis is higher than that having metastatic lesions in both sections of liver, P<0. 01. In patients with multiple liver metastasis confined in one section of liver, the 3-years survival rate in the group of chemoembolization-resection is higher than that of sole resection, P<0. 05. CONCLUSION In patients with liver metastasis of colorectal carcinomas, if resection of the primary lesion is feasible and the metastatic lesion is only found in one single section of the liver, resection of liver should be conducted. Chemoembolization not only has been proven to be an efficacious conservative therapy but can also pave the way for surgical operation in metastatic liver cancer. Especially when the multiple transmission is only confined to one section of liver, surgical operation conducted after chemoembolization can upgrade the thoroughness and efficacy of resection.