含奥沙利铂辅助化疗方案治疗结直肠癌可切除肝转移的预后分析  

Adjuvant oxaliplatin-containing chemotherapy improves overall survival following curative resection of colorectal liver metastases

作　　者：魏哲威[1] 张常华[1,2] 余捷[1] 吴菁[1] 何裕隆[1,2] WEI Zhe-wei;ZHANG Chang-hua;YU Jie;WU Jing;HE Yu-long(Gastrointestinal Surgery,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510080;Gastrointestinal Surgery,the Seventh Affiliated Hospital of Sun Yat-sen University,Shenzhen,Guangdong 518000,China)

机构地区：[1]中山大学附属第一医院胃肠外科中心,广东广州510080 [2]中山大学附属第七医院胃肠外科,广东深圳518000

出　　处：《热带医学杂志》2018年第9期1156-1159,1181,共5页Journal of Tropical Medicine

基　　金：国家自然科学基金(81401307;81702325);广东省自然科学基金(2017A030310565)

摘　　要：目的探讨含奥沙利铂术后辅助化疗方案对结直肠癌可切除肝转移患者的临床价值。方法回顾性分析2004年1月至2013年12月期间在中山大学附属第一医院行根治性手术的125例结直肠癌肝转移患者的总生存期和无复发生存期情况,其中66例患者术后接受了含奥沙利铂的辅助化疗。探讨含奥沙利铂辅助化疗方案对结直肠癌可切除肝转移患者预后和复发的影响。结果含奥沙利铂辅助化疗组和单纯手术组的5年总生存率分别为32.8%和20.8%(P=0.026),中位无复发生存期则分别为25.1月及15.7月(P=0.039)。多因素分析提示含奥沙利铂的辅助化疗是总生存期(HR=0.651,95%CI:0.410~0.903,P=0.042)和无复发生存期(HR=0.664,95%CI:0.441~0.999,P=0.045)独立预后影响因素。结论含奥沙利铂的辅助化疗方案能改善结直肠癌可切除肝转移患者的预后。Objective We evaluated the impact of adjuvant oxaliplatin-containing chemotherapy after radical resection of olorectal liver metastases （CLMs）. Methods Between June 2004 to December 2013, 125 patients who underwent radical resection of synchronous CLMs were reviewed retrospectively and evaluable for overall survival （OS） and disease- free survival （DFS）. Among them, 66 patients received adjuvant oxaliplatin-containing chemotherapy following CLM resection. The main prognostic factors for OS and DFS after resection of colorectal cancer metastases were investigated in univariate and multivariate analyses. Results The 5- year overall survival rate was 32.8% in the adjuvant oxaliplatin- containing chemotherapy group and 20.8% in the surgery only group （P=0.026）. Median DFS was 25.1 months in the adjuvant oxaliplatin-containing chemotherapy group and 15.7 months in the surgery-only group （P=0.039）. Adjuvant oxaliplatin- containing chemotherapy was shown by multivariate analyses to be an independent factor predicting a better OS （HR=0.651, 95%CI： 0.410-0.903, P=0.042） and a better DFS（HR=0.664, 95%（21： 0.441~0.999, P=0.045）. Conclusion Adjuvant oxaliplatin-containing chemotherapy improves prognosis for patients with resectable colorectal cancer and synchronous liver metastases.

关 键 词：结直肠癌 肝转移 辅助化疗 奥沙利铂 

分 类 号：R735.35[医药卫生—肿瘤]