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目的:比较直肠癌同时性肝转移患者同期切除与分期切除安全性及远期疗效。方法:收集从2000年1月至2015年4月北京大学肿瘤医院行手术切除的54例直肠癌同时性肝转移患者的临床病理及围手术期资料,并随访其复发及生存状况,比较同期切除组(19例)及分期切除组(35例)的安全性及远期疗效。结果:两组患者临床病理资料基本一致。同期切除组及分期切除组术后Clavien-Dindo 1级、2级、3级及4级并发症的发生率分别为10.5%(2/19)、31.6%(6/19)、5.3%(1/19)及10.5%(2/19)和8.6%(3/35)、17.1%(6/35)、25.7%(9/35)及0(0/35);差异无统计学意义(P=0.093)。但术后中位住院时间同期组明显低于分期组(同期组14d,分期组25d,P<0.001)。同期组与分期组术后中位生存期差异无统计学意义(同期组未达到,分期组39个月,P=0.649),两组术后无病生存期差异无统计学意义(同期组10个月,分期组10个月,P=0.827)。结论:直肠癌同时性肝转移患者同期切除与分期切除比较未明显增加患者围手术期并发症,而且远期疗效相似。
Objective: To compare resection and staging resection safety and long-term efficacy of concurrent liver metastasis in patients with rectal cancer. Methods: From January 2000 to April 2015, Peking University Cancer Hospital surgical resection of 54 patients with concurrent liver metastasis of patients with clinical and perioperative data, and follow-up of their recurrence and survival status, compared with the same period of resection Group (19 cases) and staged resection group (35 cases). Results: The clinical and pathological data of the two groups were basically the same. The incidences of Clavien-Dindo grade 1, grade 2, grade 3 and grade 4 postoperative complications in resection group and staged resection group were 10.5% (2/19), 31.6% (6/19), 5.3% (1) / P <0.05), P <0.05), and 10.5% (2/19) vs 8.6% (3/35), 17.1% (6/35), 25.7% (9/35) and 0 = 0.093). However, the median postoperative hospital stay was significantly lower than that of the staging group (14 days in the same period and 25 days in the staging group, P <0.001). There was no significant difference in postoperative median survival between the two groups (P> 0.05 for the same period, P = 0.649). There was no significant difference in postoperative disease-free survival between the two groups Month, staging group for 10 months, P = 0.827). Conclusion: The resection and staging resection of patients with concurrent liver metastasis of rectal cancer did not significantly increase the perioperative complications, and the long-term efficacy was similar.