超重对结直肠癌肝转移患者手术并发症和生存的影响  

Impact of overweight on postoperative complications and oncological outcome after radical hepatectomy for metastatic colorectal cancer

作　　者：王宏伟[1] 王崑[1] 包全[1] 孙谊[1] 金克敏 闫晓峦 邢宝才[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所肝胆外一科恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华肿瘤杂志》2015年第3期200-203,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金（81371868）

摘　　要：目的：探讨超重对结直肠癌肝转移患者围手术期并发症及生存的影响。方法回顾性分析2000年1月至2012年3月间192例接受结直肠癌肝转移灶切除患者的临床病理资料及围手术期并发症，并探讨超重与并发症发生率以及患者生存的关系。结果192例患者中，超重[身体质量指数（BMI）≥24]患者109例，正常体重（BMI＜24）患者83例。术后共有68例患者出现75例次手术并发症。超重并未延长手术时间（P＝0．837）、术中出血量（P＝0．272）和手术并发症的发生率（P＝0．428）。全组有173例患者可进行预后分析，其中超重患者和正常体重患者的中位生存时间分别为59和31个月，差异有统计学意义（ P＝0．016）。单因素和多因素分析均显示，超重患者的总生存情况优于正常体重患者（均P＜0．05），但两组患者无病生存情况的差异无统计学意义（P＝0．058）。结论超重并未增加肝转移患者手术并发症的发生率。与正常体重患者比较，超重患者的总生存时间可能更长。Objective To evaluate the correlation between overweight and postoperative complications and prognosis after radical hepatectomy for colorectal liver metastasis （ CRLM） .Methods A total of 192 patients who underwent hepatectomy for colorectal liver metastases between January 2000 and March 2012 were eligible for the study.We retrospectively summarized their clinicopathological data, BMI index and postoperative complications, and investigated the relation between these data and complications and prognosis.Results Of the 192 patients, 109 cases were classified as overweight with a BMI≥24 and 83 patients were classified as non-overweight with a BMI 〈24.Seventy-five complications occurred in 68 of the 192 patients （35.4%） who underwent hepatectomy.Surgical complications （ P=0.428）, operation time（P=0.837）, and blood loss （P=0.272） were not statistically significantly associated with BMI.173 patients were included to analyze the influence of overweight on oncologic outcome.The median survival for the overweight patients was 59 months, while that of non-overweight patients was 31 months （P=0.016）. The overweight patients had a longer OS assessed by both univariate analysis （ P=0.016） and multivariate analysis （P=0.031）.However, no statistical differences in disease-free survival （DFS） were detected between the overweight and non-overweight groups （ P =0.058）.Conclusions Overweight is not independently associated with an increasing complication rate.BMI does not significantly affect the CRLM-DFS, and high BMI patients might have a better overall survival.

关 键 词：结直肠肿瘤 肿瘤转移 肝 肝切除术 超重 手术后并发症 预后 

分 类 号：R735.34[医药卫生—肿瘤]