肝切除术治疗结直肠癌转移的条件性生存情况：来自结直肠肝手术转移国际合作（COLOMIC）研究的结果。
Conditional Survival After Hepatectomy for Colorectal Liver Metastasis: Results from the Colorectal Liver Operative Metastasis International Collaborative (COLOMIC).
发表日期：2023 Mar 01
作者：
Cristian D Valenzuela, Omeed Moaven, Ian B Solsky, John A Stauffer, Nico R Del Piccolo, Tanto Cheung, Carlos U Corvera, Andrew D Wisneski, Charles H Cha, Nima Pourhabibi Zarandi, Justin Dourado, Kathleen C Perry, Gregory Russell, Perry Shen
来源：
ANNALS OF SURGICAL ONCOLOGY
摘要：
完整切除结直肠肝转移癌可改善结直肠癌患者的长期生存率。然而，因为手术后生存里程碑的不同，目前关于条件生存率（CS）的数据还很有限。我们对五家胆道外科临床医学中心的Colorectal Liver Operative Metastasis International Collaborative（COLOMIC）进行了回顾性分析，研究了906例连续的CLM肝切除手术病例，利用Bayes定理和Kaplan-Meier分析计算了CS。另外，我们还对结肠癌位置、KRAS基因突变和肝外病变等其他临床病理危险因素进行了CS分析。在术后0、1、2、3年，五年CS分别为40.6％、45.3％、52.8％和65.3％，且每年都有显著改善（p <0.005）。在3年术后，右侧结肠癌和左侧结肠癌之间的CS没有显著差异。KRAS基因突变的患者在所有时间点上的CS较差（p <0.001）。肝外病变是OS和CS的不良预后因素（p <0.001）。然而，肝外病变或KRAS基因突变的患者在术后2年达到存活时期后，其CS显著改善（p <0.05）。CLM肝切除术后的五年CS随着术后生存纪律的增加而逐渐提高。虽然肝外病变和KRAS基因突变是OS的不良预后因素，但这些人群在术后2年后仍然有了改善的CS。©2023年。外科肿瘤学会。
Complete resection of colorectal liver metastasis (CLM) improves long-term survival in colorectal cancer. However, there is limited recent data on conditional survival (CS) as postoperative survival milestones are achieved post-hepatectomy.A retrospective analysis was performed on the penta-institutional Colorectal Liver Operative Metastasis International Collaborative (COLOMIC), with 906 consecutive CLM hepatectomy cases. CS was calculated using Bayes' theorem and Kaplan-Meier analysis. Additional CS analyses were performed on additional clinicopathologic risk factors, including colon cancer laterality, KRAS mutation status, and extrahepatic disease.The 5-year CS was 40.6%, 45.3%, 52.8%, and 65.3% at 0, 1, 2, and 3 years postoperatively, with significant improvements each year (p < 0.005). CS was not significantly different between right-sided and left-sided colorectal cancers by 3 years postoperatively. Patients with KRAS mutations had worse CS at all timepoints (p < 0.001). Extrahepatic disease was a poor prognostic factor for OS and CS (p < 0.001). However, CS for patients with KRAS mutations or extrahepatic disease improved significantly as 2-year, postoperative survival was achieved (p < 0.05).Five-year CS after hepatectomy for CLM improved with each passing year of survival postoperatively. Although extrahepatic disease and KRAS mutations are poor prognostic factors for OS, these populations still had improved CS after 2 years postoperatively.© 2023. Society of Surgical Oncology.