结直肠癌肝转移预后因素分析及治疗方式对生存期的影响  

Analysis of prognostic factors of hepatic metastasis of colorectal cancer and influence of the therapy on long-term survival

作　　者：赵霞[1] 叶颖江[2] 尹慕军[2] 郭鹏[2] 丘辉[2] 武将[2] 

机构地区：[1]北京世纪坛医院,北京100038 [2]北京大学人民医院

出　　处：《山东医药》2011年第8期25-27,共3页Shandong Medical Journal

摘　　要：目的研究在原发癌切除术后,结直肠癌肝转移患者的临床特征与预后之间的相关性。方法对118例结直肠癌肝转移患者13个临床病理特征进行单因素生存分析及多因素COX风险回归模型的分析。各种治疗方法对1、3、5 a生存率及中位生存期的影响应用生存寿命表法进行比较。结果手术组的生存期明显长于姑息治疗组和未治疗组。原发癌的TNM分期、术前CEA、肝转移灶的最大径和发现时间、肝外转移的存在以及原发癌切除术后的治疗方式等6个因素对结直肠癌肝转移患者的中位生存期存在显著性影响(P<0.05)。原发癌的TNM分期、术前CEA、肝转移灶的大小与结直肠癌肝转移长期生存的危险性呈正相关。结论结直肠癌肝转移患者的临床病理特征与患者预后有着密切关系。手术治疗,特别是手术联合全身化疗、肝动脉介入化疗等综合治疗比单纯治疗具有更佳的疗效。Objective To analyse the trends and the effects of pathologic features and different therapies on the prognosis of hepatic metastasis from colorecal cancer.Methods A total of 118 colorectal cancer patients with hepatic metastasis who had underwent primary cancer resection were analysed.Thirteen clinical pathologic features of primary and metastatic tumor were analysed,univariate analyses were done by the Kaplan-Meier method.Multivariate analysis was performed with the Cox Proportional Hazard Model.Results Overall survival was significantly longer in the patients undergoing liver resection compared with the patients received systemic chemothapy,HAI and the untreated patients.The primary tumor TNM stage,preoperative CEA level,the diameter of the largest metastasis leision and the time from primary tumor to metastases,the exist of extrohepatic metasrases and the therapies after the primary cancer resection obviously effect on the median survival of the hepatic metastasis of colorectal cancer（P〈0.05）.The primary tumor TNM stage,preoperative CEA level,the largest size of metastasis were proved to be associated with the long-time survival.Conclusions The clinic pathological features are significantly correlated with the prognosis of hepatic metastasis from colorecal cancer.The outcome is significantly better in the patients undergoing liver resection compared with the patients received systemic chemothapy,HAI and the untreated patients.

关 键 词：结直肠肿瘤 肿瘤转移 预后 

分 类 号：R735.3[医药卫生—肿瘤]