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Annals of surgery 不可切除的仅肝脏结直肠癌转移患者肝移植后的生存率。

影响因子：13.787 DOI：10.1097/SLA.0000000000003404

作者： Dueland S,Syversveen T,Solheim JM,Solberg S,Grut H,Bjørnbeth BA,Hagness M,Line PD 发表时间：2020-07-10 10:03:24

from：《ANNALS OF SURGERY》

keywords： Dueland SSyversveen TSolheim JMSolberg SGrut HBjørnbeth BAHagness MLine PD

关键词：

Abstract

OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplantation provided an overall survival of 60% in a previous study (SECA-I). Risk factors for death were carcinoembryonic antigen (CEA) >80 μg/L, progressive disease on chemotherapy, size of largest lesion>5.5 cm, and less than 2 years from resection of the primary tumor to transplantation. METHODS:In this prospective (SECA-II) study, we included colorectal cancer patients with nonresectable liver-only metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography scans and at least 10% response to chemotherapy. Time from diagnosis to liver transplant was required to be more than 1 year. RESULTS:At a median follow-up of 36 months, Kaplan-Meier overall survival at 1, 3, and 5 years were 100%, 83%, and 83%, respectively. Disease-free survival at 1, 2, and 3 years were 53%, 44%, and 35%, respectively. Overall survival from time of relapse at 1, 2, and 4 years were 100%, 73%, and 73%, respectively. Recurrence was mainly slow growing pulmonary metastases amenable to curative resection. Fong Clinical Risk Score of 1 to 2 at the time of diagnosis resulted in longer disease-free survival than score 3 to 4 (P = 0.044). Patients included in the present study had significantly better prognostic factors than the previous SECA-I study. CONCLUSION:Liver transplantation provides the longest overall survival reported in colorectal cancer patient with nonresectable liver metastases. Improved selection criteria give patients with nonresectable colorectal liver metastases a 5-year overall survival comparable to other indications for liver transplantation.

摘要

目的: 确定接受肝移植的不可切除的仅肝脏结直肠癌患者的总生存期和无病生存期。背景: 不可切除的结直肠癌患者接受姑息性化疗的 5 年总生存率约为 10%。在以前的研究 (SECA-I) 中，肝移植提供了 60% 的总生存率。死亡危险因素为癌胚抗原 (CEA) >80 μ g/L，化疗时病情进展，最大病灶大小> 5.5，并且从原发肿瘤切除到移植不到 2 年。方法: 在这项前瞻性 (SECA-II) 研究中，我们纳入了通过计算机断层扫描 (CT) 确定的不可切除的仅肝脏转移的结直肠癌患者/磁共振成像/正电子发射断层扫描和至少 10% 对化疗的反应。从诊断到肝移植需要 1 年以上的时间。结果: 中位随访 36 个月时，1 、 3 和 5 年的Kaplan-Meier总生存率分别为 100% 、 83% 和 83%。1 、 2 和 3 年的无病生存率分别为 53% 、 44% 和 35%。从 1 、 2 和 4 年复发时间开始的总生存期分别为 100% 、 73% 和 73%。复发主要是缓慢生长的肺转移瘤，适合根治性切除。诊断时Fong临床风险评分 1 ~ 2 分导致无病生存期长于评分 3 ~ 4 分 (P = 0.044)。纳入本研究的患者预后因素显著优于先前的SECA-I研究。结论: 肝移植提供了报道的不可切除肝转移的结直肠癌患者最长的总生存期。改进的选择标准使不可切除的结直肠癌肝转移患者的 5 年总生存率与肝移植的其他适应症相当。

期刊介绍

《ANNALS OF SURGERY》 (点击进入期刊详情)

英文简介 : Annals of Surgery is the official publication of the American Surgical Association, European Surgical Association, Southern Surgical Association, New York Surgical Society and the Philadelphia Academy of Surgery.

中文简介 : （来自Google、百度翻译）《外科年鉴》是美国外科学会、欧洲外科学会、南方外科学会、纽约外科学会和费城外科学会的官方出版物。

CIRCULATION RESEARCH 期刊中科院评价数据

新中科院分区

大类(学科)	小类(学科)	学科排名
医学	SURGERY (外科)	1/200

新发布的期刊年发文量

年度总发文量	年度论文发表量	年度综述发表量
299	288	11

总被引频次 :50355

特征因子 : 0.066690

影响因子趋势图

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