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目的探讨伴有同时性肝转移结直肠癌的外科治疗及其适应证。方法收集经外科手术治疗的116例伴有同时性肝转移的结直肠癌患者的临床资料,进行生存分析,并通过单因素分析和Cox比例风险模型多因素分析确定患者预后的影响因素。结果116例患者均行结直肠癌原发肿瘤切除,18例行同期肝转移瘤切除。围手术期死亡2例(1.7%),术后发生并发症者17例(14.7%)。全组患者5年生存率为14.29%,肝转移瘤切除患者5年生存率为32.12%。多因素分析显示,肝转移瘤切除、腹腔扩散、介入治疗和全身化疗是影响预后的最主要因素。结论伴有同时性肝转移的结直肠癌患者,选择外科手术切除肿瘤病灶,并辅助综合治疗可延长患者的生存时间。
Objective To investigate the surgical treatment and its indications of concurrent colorectal cancer with liver metastases. Methods The clinical data of 116 patients with colorectal cancer with concurrent liver metastasis who underwent surgical treatment were collected for survival analysis. The influencing factors of prognosis were determined by univariate analysis and multivariate analysis of Cox proportional hazards model. Results 116 patients underwent resection of primary tumor of colorectal cancer and 18 cases of resection of liver metastasis in the same period. Perioperative death in 2 cases (1.7%), postoperative complications in 17 cases (14.7%). The 5-year overall survival rate of patients was 14.29%. The 5-year survival rate of patients with liver metastases resection was 32.12%. Multivariate analysis showed that resection of liver metastases, intraperitoneal spread, interventional therapy and systemic chemotherapy are the most important factors affecting the prognosis. Conclusions Patients with colorectal cancer with concurrent liver metastases who underwent surgical resection of the tumor lesion and assisted with the combination therapy could prolong their survival time.