大肠癌伴肝转移患者的预后因素

目的探讨影响大肠癌伴肝转移患者预后的因素.方法1995年5月-1999年12月间本院外科手术治疗的64例大肠癌伴肝转移患者,部分患者全身化疗或肝动脉插管化疗,并对其临床资料进行统计分析.结果本组大肠癌肝转移患者占大肠癌患者10.2%.肝转移灶大小、术前CEA水平、原发灶切除、辅助治疗方式为影响生存的独立的预后因素.年龄、性别、肿瘤部位、分化程度、肝转移灶数目与预后无关.肝转移灶＞5cm、术前CEA＞100μg/ml、原发灶未切除的患者的生存时间(3.52月)显著低于其他患者(21.60月).结论治疗方式对肠癌肝转移患者预后影响显著,应积极切除原发灶、治疗转移灶.肝动脉插管化疗优于全身化疗.肝转移灶大小、术前CEA水平是重要的预后指标.

Prognostic factors of patients with liver metastases from colorectal cancer

Purpose: To elucidate which prognostic factors were the most important in the patients with simultaneous liver metastases from colorectal cancer. Methods: From May 1995 to December 1999, 64 patients operated for simultaneous liver metastases from colorectal cancer at the Department of Abdominal Surgery in this Cancer Hospital were studied. Prognostic factors were analyzed. Results: In our series, simultaneous liver metastases from colorectal cancer account for 10. 3% of the total patients. Th size of liver metastases, serum CEA value, primary tumor resection, adjuvant treatment modality were the most significant variable in the sruvival analysis. There were no significant difference in survival based on age, sex, primary tumor position, tumor differentiation, number of liver metastases. Median survival of 15 patients with the size of liver metastases >5 cm, pre-operation CEA level > 100 j.i.g/ml and unresectable primary tumor were 3. 52 months. The survival of this group was sinificantly different from the other patients (21. 60 months). Conclusions: Treatment modalities had significant influence on survival of patients with liver metastasis from colorectal cancer. Primary tumor resection and liver resection should be considered standard therapy for all suitable patients with colorectal metastases isolated to the liver. Regional arterial chemotherapy was superior to systemic chemotherapy. Size of liver metastases and preoperation CEA level were important prognostic factors.