BJS：结直肠癌肝转移肝切除术后强化随访无益
2012-03-06 MedSci MedSci原创
英国学者近期发表于《英国外科杂志》（British Journal of Surgery）的一项荟萃分析表明，关于结直肠癌肝转移肝切除术后随访研究的资料很少，早期强化随访未被发现可增加患者生存益处。 研究者系统回顾了2003年1月～2010年3月发表的文献，并进行了相关的研究分析。 结果显示，共有35项研究（包含7330例患者）被纳入分析，仅5项有专门的随访数据。 接受早期强
英国学者近期发表于《英国外科杂志》（British Journal of Surgery）的一项荟萃分析表明，关于结直肠癌肝转移肝切除术后随访研究的资料很少，早期强化随访未被发现可增加患者生存益处。
研究者系统回顾了2003年1月～2010年3月发表的文献，并进行了相关的研究分析。
结果显示，共有35项研究（包含7330例患者）被纳入分析，仅5项有专门的随访数据。
接受早期强化随访的患者中位生存期为39.8个月，5年总生存率为41.9%。
接受常规随访的患者中位生存期为40.2个月，5年总生存率为38.4%。
相关链接：Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases.
Background:
The evidence surrounding optimal follow-up after liver resection for colorectal metastases remains unclear. A significant proportion of recurrences occur in the early postoperative period, and some groups advocate more intensive review at this time.
Methods:
A systematic review of literature published between January 2003 and May 2010 was performed. Studies that described potentially curative primary resection of colorectal liver metastases that involved a defined follow-up protocol and long-term survival data were included. For meta-analysis, studies were grouped into intensive (more frequent review in the first 5 years after resection) and uniform (same throughout) follow-up.
Results:
Thirty-five studies were identified that met the inclusion criteria, involving 7330 patients. Only five specifically addressed follow-up. Patients undergoing intensive early follow-up had a median survival of 39·8 (95 per cent confidence interval 34·3 to 45·3) months with a 5-year overall survival rate of 41·9 (34·4 to 49·4) per cent. Patients undergoing routine follow-up had a median survival of 40·2 (33·4 to 47·0) months, with a 5-year overall survival rate of 38·4 (32·6 to 44·3) months.
Conclusion:
Evidence regarding follow-up after liver resection is poor. Meta-analysis failed to identify a survival advantage for intensive early follow-up.
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#切除术#
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#肝切除术#
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#肝转移#
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#结直肠#
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