结直肠癌同时性肝转移患者行同期手术切除的预后分析

目的 探讨实施结直肠癌肝转移同期切除术患者的预后影响因素.方法 回顾性分析1993年1月至2003年1月间,在我院实施结直肠癌肝转移同期切除术且获得随访的44例患者的临床资料,应用Kaplan-Meier法进行生存分析,Log rank检验进行统计学比较,Cox比例风险模型进行多因素分析.结果 44例患者的1、3、5年生存率分别为86.3%、40.9%和25.0%.单因素分析显示,脉管瘤栓和区域淋巴结转移与患者术后生存有关;而性别、年龄、原发灶位置、肿瘤大体类型、分化程度、转移瘤数目以及转移瘤分布与术后生存无关.多因素分析显示,区域淋巴结转移是影响预后的独立危险因素.结论 对于结直肠癌同时性肝转移患者实施同期手术切除,可以获得较好的疗效,其中无淋巴结转移的患者疗效最佳.

Prognostic factors of colorectal cancer patients with synchronous liver metastasis treated with simultaneous liver and colorectal resection

Objective To analyze the prognostic factors of colorectal cancer patients with synchronous liver metastasis treated by simultaneous colorectal and liver resection. Methods The clinical and follow-up data of 44 colorectal cancer patients with synchronous liver metastases who underwent simultaneous colorectal and liver resection from Jan. 1993 to Jan.2003 were analyzed retrospectively. Survival rate was estimated by Kaplan-Meier method, and was compared using log-rank test. Prognostic factors were analyzed by multivariate Cox proportional hazards model. Results The overall 1-,3- and 5-year survival rates were 86.3%,40.9% and 25.0%,respectively. The lymph node metastasis and vascular invasion by cancer cells from the primary tumour were found to affect prognosis significantly, while gender, age, tumor location, histopathological types, the number and distribution of liver metastases were not. Multivariate analysis revealed that the lymph node metastasis was the only independent prognostic factor. Conclusion Simultaneous liver and colorectal resection can be performed and may achieve good outcome in colorectal cancer patients with synchronous liver metastases, especially in those without lymph node metastasis.