The aim of this study was to identify prognostic factors affecting intrahepatic progression-free survival (ihPFS) and overall survival (OS) in patients with colorectal cancer liver metastases (CRCLM) undergoing portal vein embolization (PVE) and subsequent (extended) right hemihepatectomy. A total of 59 patients (mean age: 60.8 ± 9.3 years) with CRCLM who underwent PVE in preparation for right hemihepatectomy were included. IhPFS and OS after PVE were calculated using the Kaplan-Meier method. Cox regression analyses were conducted to investigate the association between the following factors and survival: patient age, laterality of the colorectal cancer (right- versus left-sided), tumor location (colon versus rectal cancer), time of occurrence of hepatic metastases (synchronous versus metachronous), baseline number and size of hepatic metastases, presence or absence of metastases in the future liver remnant (FLR) before PVE, preoperative carcinoembryogenic antigen (CEA) levels, time between PVE and surgery, history of neoadjuvant or adjuvant chemotherapy, and the presence or absence of extrahepatic disease before PVE. Median follow up was 18 months. The median ihPFS was 8.2 months (95% confidence interval: 6.2-10.2 months), and median OS was 34.1 months (95% confidence interval: 27.3-40.9 months). Laterality of the primary colorectal cancer was the only statistically significant predictor of ihPFS after PVE (hazard ratio (HR) = 2.242; 95% confidence interval: 1.125, 4.465; p = 0.022), with patients with right-sided colorectal cancer having significantly shorter median ihPFS than patients with left-sided cancer (4.0 ± 1.9 months versus 10.2 ± 1.5 months; log rank test: p = 0.018). Other factors, in particular also the presence or absence of additional metastases in the FLR, were not associated with intrahepatic progression-free survival. The presence of extrahepatic disease was associated with worse OS (HR = 3.050, 95% confidence interval: 1.247, 7.459; p = 0.015).

译文

这项研究的目的是确定影响接受门静脉栓塞 (PVE) 和随后 (扩展) 右半肝切除术的大肠癌肝转移 (CRCLM) 患者肝内无进展生存期 (ihPFS) 和总生存期 (OS) 的预后因素。总共包括59例CRCLM患者 (平均年龄: 60.8 ± 9.3岁),他们接受了PVE准备进行右半肝切除术。使用Kaplan-Meier方法计算PVE后的IhPFS和OS。进行Cox回归分析以调查以下因素与生存率之间的关系: 患者年龄,结直肠癌的偏向性 (右侧与左侧),肿瘤位置 (结肠癌与直肠癌),肝转移发生时间 (同步与异时),肝转移的基线数量和大小,PVE前未来肝残留 (FLR) 是否存在转移,术前癌胚抗原 (CEA) 水平,PVE与手术之间的时间,新辅助或辅助化疗史以及PVE前是否存在肝外疾病。中位随访时间为18个月。ihPFS中位数为8.2个月 (95% 置信区间: 6.2-10.2个月),OS中位数为34.1个月 (95% 置信区间: 27.3-40.9个月)。原发性结直肠癌的偏侧性是PVE后ihPFS的唯一具有统计学意义的预测指标 (风险比 (HR) = 2.242; 95% 置信区间: 1.125,4.465; p = 0.022),右侧结直肠癌患者的中位ihPFS明显短于左侧癌患者 (4.0 ± 1.9个月对10.2 ± 1.5个月; 对数秩检验: p = 0.018)。其他因素,特别是FLR中是否存在其他转移,与肝内无进展生存期无关。肝外疾病的存在与较差的OS相关 (HR = 3.050,95% 置信区间: 1.247,7.459; p = 0.015)。

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