Cắt bỏ kết hợp di căn gan-phổi do ung thư đại trực tràng cho thấy kết quả cải thiện so với hóa trị đơn độc

Springer Science and Business Media LLC - Tập 398 - Trang 265-276 - 2013
Georgios Meimarakis1, Martin Angele1, Claudius Conrad2, Rolf Schauer3, Rolf Weidenhagen1, Alexander Crispin4, Clemens Giessen5, Gerhard Preissler1, Max Wiedemann4, Karl-Walter Jauch1, Volker Heinemann5, Sebastian Stintzing5, Rudolf A. Hatz1, Hauke Winter1
1Department of General Thoracic Surgery, University of Munich–Grosshadern, Munich, Germany
2Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
3Department of Surgery, Traunstein Hospital, Traunstein, Germany
4Department of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany
5Department of Oncology and Comprehensive Cancer Center, University of Munich–Grosshadern, Munich, Germany

Tóm tắt

Mục tiêu của nghiên cứu hồi cứu này là đánh giá sự sống sót của bệnh nhân sau khi cắt bỏ di căn gan và phổi do ung thư đại trực tràng để xác định các yếu tố dự đoán sống sót lâu dài. Bệnh nhân nhận hóa trị đơn thuần được so sánh với bệnh nhân nhận phẫu thuật và hóa trị trong phân tích cặp so khớp theo các tiêu chí sau: giai đoạn UICC, mức độ phân loại và ngày xuất hiện khối u nguyên phát ban đầu. Tổng cộng có 30 bệnh nhân với di căn gan và phổi của ung thư đại trực tràng đã trải qua phẫu thuật cắt bỏ. Trong 20 trường hợp, đã đạt được cắt bỏ hoàn toàn (tuổi thọ trung bình, 67 tháng). Cắt bỏ không hoàn toàn và mức độ kháng nguyên carcinogenic (CEA) tăng trước phẫu thuật là các yếu tố nguy cơ độc lập cho sự sống sót giảm. Những bệnh nhân phát triển di căn phổi trước khi xuất hiện di căn gan có tiên lượng xấu nhất. Cắt bỏ phẫu thuật đã làm tăng đáng kể thời gian sống so với hóa trị đơn độc trong phân tích cặp so khớp (65 so với 30 tháng, p = 0.03). Cắt bỏ không hoàn toàn và mức CEA tăng là các yếu tố dự đoán kết quả kém. Phân tích cặp so khớp xác nhận rằng cắt bỏ phẫu thuật kết hợp với hóa trị dường như vượt trội hơn so với hóa trị đơn độc.

Từ khóa

#di căn gan-phổi #ung thư đại trực tràng #cắt bỏ #hóa trị #sống sót lâu dài

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