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目的:探讨结直肠癌同时性肝转移的有效治疗方法。方法:对1996～2004年收治的46例结直肠癌同时性肝转移的临床资料和随访资料进行回顾性分析。根据治疗方法的不同分为3组:A组21例,为一期切除原发灶和肝转移灶并经肝动脉和门静脉置泵化疗者;B组15例,为单纯原发灶切除并经肝动脉和门静脉置泵化疗者;C组10例,为原发灶和肝转移灶均未能切除而仅行肝动脉和门静脉置泵化疗者。用KaplanMeier法对病人的生存时间作统计分析。结果:A、B、C3组术后中位生存期分别为38、20和13个月;各组之间术后生存时间的比较均有显著统计学差异(P<0.01)。结论:结直肠癌原发灶和肝转移灶一期手术切除并经肝动脉和门静脉置泵化疗的疗效最好;肝转移灶无法切除者能将原发灶切除并经肝动脉和门静脉置泵化疗也可取得较好的疗效;原发灶和肝转移灶未能切除而仅经肝动脉和门静脉置泵化疗的疗效相对较差。对结直肠癌同时性肝转移应采取以手术切除为主的综合措施进行积极治疗。
Objective: To explore the effective treatment of concurrent liver metastasis of colorectal cancer. Methods: The clinical data and follow-up data of 46 patients with concurrent liver metastasis from 1996 to 2004 were retrospectively analyzed. According to the different treatment methods are divided into three groups: A group of 21 cases, a primary resection of the liver and liver metastases by the hepatic artery and portal vein pump chemotherapy; B group of 15 cases, simple primary resection and by Hepatic artery and portal vein pump chemotherapy; C group of 10 cases, the primary tumor and liver metastases were not resected but only hepatic artery and portal vein pump chemotherapy. The KaplanMeier method was used to analyze the patient’s survival time. Results: The median postoperative survival time was 38, 20 and 13 months in group A, B and C3, respectively. There was significant difference in postoperative survival time between groups (P <0.01). CONCLUSION: The primary resection of colorectal cancer and liver metastasis and the treatment by hepatic artery and portal vein pump chemotherapy is the best; hepatic metastasis unresectable primary tumor can be removed and the hepatic artery and portal vein pump Chemotherapy can also get better curative effect; the primary tumor and liver metastasis can not be resected, but only by the hepatic artery and portal vein pump chemotherapy is relatively poor. For colorectal cancer with simultaneous liver metastasis should be taken to the main surgical resection-based comprehensive measures for active treatment.