- 期刊
Surgical Management of Pulmonary Metastases of Colorectal Cancer
以手術治療大腸直腸癌肺轉移病患之成果分析
摘要
目的 我們知道未治療的第四期大腸直腸癌患者預後極差，而最常發生的大腸直腸癌轉移處爲肝臟與肺臟。對肺臟轉移這群病患而言，目前已知可能最有效的治療方法就是手術切除。故作者希望提供成大醫院相關病歷，以進一步探討手術之於大腸直腸肺轉移療效與找出可能的相關預後因子。 方法 我們以回朔性方式收集了從1998年1月至2007年12月間在成大醫院接受治癒性(curative)大腸直腸癌肺轉移的40位病患病歷。資料收集終點(endpoints)爲病患死亡或是疾病復發。 結果 這40位病患共接受了47次肺轉移切除手術，且無任何手術相關致死率。其5年無病存活率與總存活率分別爲36.8%與38.8%。肺轉移切除後無病存活時間以及肺轉移腫瘤大小與5年總存活率是具有統計上的相關性的。至於5年無病存活率，則是與術前腫瘤指數CA199高低有關。 結論 肺轉移切除手術之於大腸直腸癌肺轉移患者相對上而言是安全，且可以延長存活時間的方式。
並列摘要
Purpose. The most common metastatic sites of colorectal cancer are the liver and lung. Patients with untreated stage IV colorectal cancer have a very poor prognosis. Only surgical intervention seems to be effective in cases of pulmonary metastases, for which there exists no definitive prognostic factors. Therefore, in this study we analyzed case records and attempted to identify potential prognostic factors and more effective methods of management of pulmonary metastases. Methods. Forty consecutive cases of pulmonary metastases from January 1998 to December 2007 in which curative pulmonary metastasectomy was performed were examined retrospectively by reviewing medical charts and the outcome assessed, the primary endpoint being death and the secondary endpoint being disease recurrence. Results. The five-year disease-free and overall survival rates in these patients were 36.8% and 38.8%, respectively. A total of 47 lung resections were performed, with no instances of postoperative mortality. Only the post-thoracotomy disease-free interval and tumor size less than 3 centimeter were found to be a meaningful prognostic factor of five-year overall survival, although the normal serum CA199 level seemed to contribute to a better outcome. Conclusion. Pulmonary metastasectomy in cases of colorectal cancer is relatively safe and assists in improving survival.
延伸閱讀
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