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題名 | 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 |
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作者姓名(中文) | 林劭潔; 林博文; 賴吾為; 曾堯麟; 吳明和; 李政昌; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 21:3 2010.09[民99.09] |
頁次 | 頁130-137 |
分類號 | 416.245 |
關鍵詞 | 肺轉移; 大腸直腸癌; 手術切除; Pulmonary metastasis; Colorectal cancer; Surgical management; |
語文 | 英文(English) |
中文摘要 | 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 移處為肝臟與肺臟。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) 為病患死 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為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。 |
英文摘要 | 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. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。