结肠直肠癌根治术后有40～50%的病人有肝脏复发,预后很差,复发后平均生存仅6～9个月。原发灶的癌细胞可以经门静脉系统进入肝脏,形成微小沉积灶,术中不能发现,以后可以进一步发展成较大的肝转移结节。Dukes 证实直肠癌切除标本中17%有静脉扩散。Fisher 等发现结直肠癌手术病人32%在肠系膜静脉中发现癌细胞。抑制这些微小转移灶是辅助性化疗的主要目的。不少前瞻性研究证明全身用药效果不好,目前倾向于通过肝动脉或门静脉用药,而且应在术后尽快开始。作者报告1981～1986年的378例结肠或直肠腺癌患者,这些患者均行根治手术并经病理证实,术中未发现转移。患者随机分为二组,对照组187例,化疗组191例,两组年龄、性别、肿瘤部位、Dukes 病理分期及 CEA 检查结果均无显著差异。切除原发灶的 After resection of colorectal cancer, 40 to 50% of patients have liver recurrence and the prognosis is poor. The average survival after relapse is only 6 to 9 months. The cancer cells of the primary tumor can enter the liver through the portal venous system and form tiny deposition foci, which can not be found during surgery. Later, they can be further developed into larger liver metastatic nodules. Dukes confirmed that 17% of the resection specimens in the rectal cancer had venous spread. Fisher et al. found that 32% of colorectal cancer patients found cancer cells in the mesenteric vein. Inhibiting these micrometastases is the main purpose of adjuvant chemotherapy. Many prospective studies have shown that systemic medications are not effective and currently tend to be administered via the hepatic artery or portal vein and should be started as soon as possible after surgery. The authors reported 378 patients with colon or rectal adenocarcinoma from 1981 to 1986. All of these patients underwent radical surgery and confirmed by pathology. No metastases were found during the operation. The patients were randomly divided into two groups, 187 in the control group and 191 in the chemotherapy group. There was no significant difference in age, gender, tumor location, pathological staging of Dukes, and CEA. Removal of the primary foci