{"title":"原发肿瘤临床病理因素对直肠肝转移肝切除术后预后的影响","authors":"Tomofumi Uotani, Takeshi Takamoto, Satoshi Nara, Daisuke Ban, Takahiro Mizui, Konosuke Moritani, Shunsuke Tsukamoto, Yukihide Kanemitsu, Tsutomu Fujii, Minoru Esaki","doi":"10.1002/ags3.12917","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023. Prognostic factors were investigated using univariable and multivariable analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The cohort consisted of 113 males and 44 females, with a median age of 60 years. Lateral lymph node dissection was performed in 48 patients, of which 11 had positive nodes. Multivariable analysis revealed lateral lymph node metastasis (HR 5.86; 95% CI 2.40–14.2; <i>p</i> = 0.0001) and perineural invasion (HR 2.83; 95% CI 1.36–5.88; <i>p</i> = 0.005) as independent prognostic factors. After curative hepatectomy, 73.3% of patients with these two factors showed early recurrence within 6 months, requiring nonsurgical treatment.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Lateral lymph node metastasis and perineural invasion of the primary tumor were prognostic factors after resection of rectal liver metastases. Patients with these factors required nonsurgical treatment in the early postoperative period.</p>\n </section>\n </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"814-821"},"PeriodicalIF":3.3000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12917","citationCount":"0","resultStr":"{\"title\":\"Impact of primary tumor clinicopathological factors on prognosis after hepatic resection for rectal liver metastases\",\"authors\":\"Tomofumi Uotani, Takeshi Takamoto, Satoshi Nara, Daisuke Ban, Takahiro Mizui, Konosuke Moritani, Shunsuke Tsukamoto, Yukihide Kanemitsu, Tsutomu Fujii, Minoru Esaki\",\"doi\":\"10.1002/ags3.12917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023. Prognostic factors were investigated using univariable and multivariable analyses.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The cohort consisted of 113 males and 44 females, with a median age of 60 years. Lateral lymph node dissection was performed in 48 patients, of which 11 had positive nodes. Multivariable analysis revealed lateral lymph node metastasis (HR 5.86; 95% CI 2.40–14.2; <i>p</i> = 0.0001) and perineural invasion (HR 2.83; 95% CI 1.36–5.88; <i>p</i> = 0.005) as independent prognostic factors. After curative hepatectomy, 73.3% of patients with these two factors showed early recurrence within 6 months, requiring nonsurgical treatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Lateral lymph node metastasis and perineural invasion of the primary tumor were prognostic factors after resection of rectal liver metastases. Patients with these factors required nonsurgical treatment in the early postoperative period.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8030,\"journal\":{\"name\":\"Annals of Gastroenterological Surgery\",\"volume\":\"9 4\",\"pages\":\"814-821\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-01-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12917\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Gastroenterological Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12917\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Gastroenterological Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12917","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景直肠癌肝转移的治疗是基于结直肠癌肝转移的研究数据而考虑的。本研究旨在阐明原发病变的临床病理因素,包括直肠癌特异性因素如外侧淋巴结转移对肝切除术后预后的影响。方法对2010年1月至2023年6月接受根治性手术治疗的直肠癌肝转移患者进行单中心回顾性研究。采用单变量和多变量分析研究预后因素。结果该队列男性113例,女性44例,中位年龄60岁。48例患者行侧淋巴结清扫,其中11例淋巴结阳性。多变量分析显示外侧淋巴结转移(HR 5.86;95% ci 2.40-14.2;p = 0.0001)和神经周围侵犯(HR 2.83;95% ci 1.36-5.88;P = 0.005)为独立预后因素。有这两种因素的患者在根治性肝切除术后6个月内早期复发的占73.3%,需要非手术治疗。结论直肠肝转移瘤切除后,侧淋巴结转移和原发肿瘤的神经周围浸润是影响预后的因素。有这些因素的患者在术后早期需要非手术治疗。
Impact of primary tumor clinicopathological factors on prognosis after hepatic resection for rectal liver metastases
Background
Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.
Methods
This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023. Prognostic factors were investigated using univariable and multivariable analyses.
Results
The cohort consisted of 113 males and 44 females, with a median age of 60 years. Lateral lymph node dissection was performed in 48 patients, of which 11 had positive nodes. Multivariable analysis revealed lateral lymph node metastasis (HR 5.86; 95% CI 2.40–14.2; p = 0.0001) and perineural invasion (HR 2.83; 95% CI 1.36–5.88; p = 0.005) as independent prognostic factors. After curative hepatectomy, 73.3% of patients with these two factors showed early recurrence within 6 months, requiring nonsurgical treatment.
Conclusions
Lateral lymph node metastasis and perineural invasion of the primary tumor were prognostic factors after resection of rectal liver metastases. Patients with these factors required nonsurgical treatment in the early postoperative period.