手术切除联合化疗对晚期结肠癌肝转移患者生存状况的影响

目的：探讨手术切除联合化疗对晚期结肠癌肝转移患者生存状况的影响。方法选择晚期结肠癌肝转移患者102例，将采用手术切除联合化疗的35例患者纳入观察组，将单纯采用化疗的67患者纳入对照组。随访3年，观察两组患者治疗开始至肿瘤病灶进展的时间（ TTP），化疗过程中出现的不良反应，对比两组患者的1、2、3年累积生存率。结果观察组患者共化疗160个疗程，平均4．57个疗程，TTP为14个月；对照组患者共化疗359个疗程，平均5．35个疗程，TTP为8个月，两组之间差异有统计学意义（P＜0．05）。观察组患者贫血发生率显著高于对照组（P＜0．05），其余不良反应发生率差异无统计学意义（P＞0．05）。观察组中位生存时间为26．5个月，对照组中位生存时间为22．7个月，差异有统计学意义（P＜0．05）。观察组1、2、3年生存率分别为88．6％，57．1％和42．9％；对照组1、2、3年生存率分别为71．6％，44．8％和34．3％。其中1年生存率两组之间差异显著（P＜0．05），2、3年生存率两组之间的差异无统计学意义（P＞0．05）。结论手术联合化疗治疗晚期结肠癌肝转移患者不会增加化疗的不良反应，可以提高患者的疗效和生存率。有手术指征的晚期结肠癌肝转移患者应积极采取手术治疗。

Effect of Surgical Resection Combined with Chemotherapy on the Survival of Patients with Advanced Colorectal Cancer Liver Metastasis

Objective To investigate the effect of surgical resection combined with chemotherapy on the survival of pa -tients with advanced colorectal cancer liver metastasis .Methods 102 patients with advanced colon cancer liver metastasis were selected.35 patients with surgical resection combined with chemotherapy were the observation group ,and 67 patients treated with chemotherapy were the control group .Follow up was 3 years,till TTP the adverse reactions occurred .1-,2-and 3-year cumulative survival rates of the 2 groups were compared .Results In the observation group ,160 patients were treated by chemotherapy ,and the average was 4.57 courses,TTP was 14 months.The control group was treated with 359 courses of chemotherapy ,the average was 5.35 courses,TTP was 8 months,and the difference between the two groups (P<0.05).The incidence of anemia in the ob-servation group was significantly higher than that of the control group (P<0.05),and the last adverse reactions was not statisti-cally significant(P>0.05).In the observation group,the median survival time was 26.5 months,and the median survival time was 22.7 months in the control group,the difference was statistically significant(P<0.05).1-,2-and 3-year survival rates of the observation group were 88.6%,42.9%and 57.1%,respectively,and 34.3%,71.6%,44.8% of the control group.There was significant difference in 1-year survival rate(P<0.05),the difference in 2-and 3-year survival rate was not statistically significant (P>0.05).Conclusion Surgery combined with chemotherapy for advanced colon cancer patients does not increase the side effects of chemotherapy ,it can improve efficacy and survival .Patients of advanced colorectal cancer with liver metastases in sur-gery testified should be treated actively .