Metastatic tumor doubling time: Most important prehepatectomy predictor of survival and nonrecurrence of hepatic colorectal cancer metastasis

被引:55
作者
Tanaka, K [1 ]
Shimada, H [1 ]
Miura, M [1 ]
Fujii, Y [1 ]
Yamaguchi, S [1 ]
Endo, I [1 ]
Sekido, H [1 ]
Togo, S [1 ]
Ike, H [1 ]
机构
[1] Yokohama City Univ, Sch Med, Dept Surg 2, Minami Ku, Yokohama, Kanagawa 2320024, Japan
关键词
D O I
10.1007/s00268-003-7088-3
中图分类号
R61 [外科手术学];
学科分类号
摘要
We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection (n = 144) for colorectal cancer liver metastases were studied retrospectively to identify factors that influence overall survival and recurrence in the remnant liver. Overall 5-year survival and nonrecurrence rates were 49.8% and 50.8%, respectively. By multivariate analysis, large liver tumors (p = 0.038), p53 expression by the liver tumor (p = 0.011), and a short liver metastasis doubling time (less than or equal to45 days,p = 0.013) negatively affected survival; doubling times > 45 days (adjusted relative risk 0.06; p < 0.001) positively influenced disease-free survival. In patients with remnant liver recurrence, a short doubling time was associated with short disease-free intervals (7.3 +/- 6.2 months), multiple metastases (63.6%), and fewer attempts at repeat hepatectomy (22.7%). The doubling time deter-mines tumor size and reflects the patient's immune and nutritional status. A short doubling time is the most reliable risk factor for multiple metastases, early recurrence, and poor prognosis. Further studies with a larger number of patients are needed to confirm this conclusion.
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页码:263 / 270
页数:8
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