临床危险评分体系对结直肠癌肝转移患者预后的预测意义  

Prognostic significance of clinical risk score system after resection of hepatic metastases from colorectal cancer

作　　者：金克敏 闫晓峦 王崑[1] 孙谊[1] 王宏伟[1] 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胰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12期913-916,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金（81371868）

摘　　要：目的验证临床危险评分（CRS）体系对结直肠癌肝转移患者预后的预测意义。方法收集2000年1月至2014年8月于北京大学肿瘤医院行肝切除的294例结直肠癌肝转移患者的临床病理资料，并随访其复发和生存状况，统计分析不同CRS患者的预后差异。结果全组294例结直肠癌肝转移患者的中位随访时间为19个月，中位生存时间和中位无病生存时间分别为35和11个月，术后1、3、5年生存率分别为89．0％、49．0％和35．7％，术后1、3、5年无病生存率分别为47．2％、22．2％和18．2％。CRS0、1、2、3、4、5分患者的中位生存时间分别为64、59、33、35、17和15个月，差异有统计学意义（P=O．002）；中位无病生存时间分别为16、19、13、10、4和6个月，差异有统计学意义（P〈0．001）。CRS0～2分组和CRS3～5分组患者的中位生存时间分别为44和33个月，差异有统计学意义（P=0．022）；中位无病生存时间分别为15和8个月，差异有统计学意义（P〈0．001）。结论CRS体系能预测结直肠癌肝转移患者术后的预后，对患者治疗策略的制订有参考意义。Objective To validate the prognostic significance of Clinical Risk Score （CRS） system proposed by Fong et al. after hepatectomy of liver metastasis from colorectal cancer. Methods The clinicopathological data were collected retrospectively from 294 patients with hepatic metastases from colorectal cancer who received liver resection between January 2000 and August 2014 in Peking University Cancer Hospital. Routine follow-up wa~ done by outpatient interview or telephone. Statistical analysis was conducted to compare the survival of different CRS patients. Results After a median follow-up of 19 months （2-129 months） for all the 294 patients, the median overall survival and disease-free survival were 35 months and 11 months, respectively. Tile postoperative 1-, 3- and 5-year overall survival rates were 89.0%, 49.0%, and 35.7%, and the disease-free survival rates were 47.2%, 22.2%, and 18.2%, respectively. For the six different groups with CRS of 0, 1, 2, 3, 4, 5 accordingly, the median overall survival was 64, 59, 33, 35, 17 and 15 months, respectively, showing a significant difference （P=0.002）, and the median disease-free survival was 16, 19, 13, 10, 4 and 6 months, respectively, showing also a significant difference （P〈0.001）. For patients whose CRS were 0-2 and 3-5, the median overall survival was 44 and 33 months, respectively, with a significant difference between them （P= 0.022） , and the median disease-free survival was 15 and 8 months, respectively, with also a significant difference （P〈0.001）. Condusion This CRS system may predict the prognosis for patients with hepatic metastasis from colorectal cancer after hepatectomy, therefore to provide useful reference for making treatment plan for those patients.

关 键 词：结直肠肿瘤 肿瘤转移 肝 肝切除术 临床危险评分 预后 

分 类 号：R735.34[医药卫生—肿瘤]