Effect on Liver Metastases of Intraoperative and Postoperative Portal Vein Chemotherapy and Combined with FOLFOX4 regimen chemotherapy for Patients with Obstrutive Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XIAShu-sen ,  WANGChong-shu , ZHANGGuang-jun , ZHOUTong

Department of Gastrointestinal Surgery, The Affiliated Hospital, Chuanbei Medical College, Nanchong 637000, Sichuan Province, China;

Corresponding?author：

WANGChong-shu, Email: chongs-wang@163.com

Keywords：

Colorectal cancer; Obstruction; Chemotherapy; Liver metastases; Portal vein

DOI：

10.7507/1007-9424.20160016

Video：

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Objective To explore the effect of liver metastases of intraoperative and postoperative portal vein chemotherapy and combined with folfox4 regimen chemotherapy for patients with obstrutive colorectal cancer. Methods A total of 94 obsrutive colorectal cancer patients that could be radical resection were collected from February 2007 to May 2011 in our hospital and divided into two group. Forty-six patients in treatment group received portal vein chemotherapy after the portal vein pump were placed intraoperative, and 3-4 weeks after operation taken FOLFOX4 chemotherapy combined with portal vein infusion chemotherapy 6 courses. Forty-eight patients in the control group received only FOLFOX4 chemotherapy 6 courses 3-4 weeks after operation. Ninety-four patients were followed up for 3 years to observe the incidence of postoperative liver metastasis, at the same time comparing two groups of clinic toxicity during chemotherapy. Results In three years after operation the incidence of liver metastasis were 21.7% in treatment group (10 cases had hepatic metastases), 58.3% in control group (28 cases had liver metastases), the difference in two groups was statistically significant(P < 0.01). Comparing the clinical toxicity in two group, AST in treatment group increased on first day (P < 0.01), and recovered normal on third day (P > 0.05) after operation. There were no marked difference in renal function, ALT, ALP, GGT, and LDH of liver function, medullary restraining, and reaction of gastrointestinal tract (P > 0.05). Conclusion Chemotherapy via portal vein intraoperative and postoperativ combined postoperative FOLFOX4 chemotherapy can reduce the risk of postoperative liver metastasis for the patients with obstrutive colorectal cancer.

Citation： XIAShu-sen, WANGChong-shu, ZHANGGuang-jun, ZHOUTong. Effect on Liver Metastases of Intraoperative and Postoperative Portal Vein Chemotherapy and Combined with FOLFOX4 regimen chemotherapy for Patients with Obstrutive Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(1): 60-64. doi: 10.7507/1007-9424.20160016 Copy

1.	Jiang JK, Lan YT, Lin TC, et al. Primary vs. delayed resection for obstructive left-sided colorectal cancer:impact of surgery on patient outcome. Dis Colon Rectum, 2008, 51(3):306-311.
2.	Chen HS, Sheen-Chen SM. Obstruction and perforation in colore-ctal adenocarcinoma:an analysis of prognosis and current trends. Surgery, 2000, 127(4):370-376.
3.	Lee YM, Law WL, Chu KW, et al. Emergency surgery for obstructing colorectal cancers:a comparison between right-sided and left-sided lesions. J Am Coll Surg, 2001, 192 (6):719-725.
4.	Huang TJ, Wang JY, Lee LW, et al. Emergency one-stage surgery for obstructing left-sided colorectal carcinomas. Kaohsiung J Med Sci, 2002, 18(7):323-328.
5.	De Salvo GL, Gava C, Pucciarelli S, et al. Curative surgery for obstru-ction from primary left colorectal carcinoma:primary or staged resection? Cochrane Database Syst Rev, 2004, 19(2):CD002101.
6.	Yang ZL, Wang L, Kang L, et al. Clinicopathologic Characteristics and Outcomes of Patients with Obstructive Colorectal Cancer. J Gastrointest Surg, 2011, 15(7):1213-1222.
7.	戴起寶, 蘭斌, 許東坡.門靜脈插管化療防治結直腸癌術后肝轉移.福建醫科大學學報, 2003, 37(4):426-427.
8.	胡曉平, 王小平, 鄒國英, 等.門靜脈插管化療預防結直腸癌術后肝轉移的效果.實用臨床醫學, 2011, 12(8):66-67.
9.	Yu DS, Li Y, Huang XE, et al. Effect of portal vein chemotherapy on liver metastasis after surgical resection of colorectal cancer. Asian Pac J Cancer Prev, 2012, 13 (9):4699-4701.
10.	周輝, 吳纓, 牟洪超, 等.經門靜脈和肝動脈灌注化療治療不可切除的結直腸癌肝轉移的臨床研究.腫瘤學雜志, 2015, 25 (1):51-55.
11.	賴瑋婧, 汪曉東, 陳海燕, 等.梗阻型中下段直腸腸癌一期吻合手術的臨床效果.中國普外基礎與臨床雜志, 2009, 16(11):918-921.
12.	郝晉, 楊廷翰, 蒲怡, 等.梗阻型結直腸癌外科治療中運用快速流程的安全性.中國普外基礎與臨床雜志, 2010, 17(12):1314-1317.
13.	周際昌.實用腫瘤內科學.北京:人民衛生出版社, 1999:23-35.
14.	張思維, 雷正龍, 李光琳, 等.中國腫瘤登記地區2006年腫瘤發病和死亡資料分析.中國腫瘤, 2010, 19(6):356-365.
15.	陳顥, 張劍軍, 孟志強, 等.結直腸癌伴肝轉移9l例患者的多因素預后分析.腫瘤, 2008, 28(2):153-156.
16.	Goos JA, Coupe VM, Diosdado B, et al. Aurora kinase A(AUR-KA)expression in colorectal cancer liver metastasis is associated with poor prognosis. Br J Cancer, 2013, 109(9):2445-2452.
17.	劉傳淵, 張森, 高楓, 等. Dukes' C期結直腸癌異時性肝轉移相關因素分析.中國腫瘤臨床, 2010, 37(6):313-316.
18.	王勝利, 何新陽.結直腸癌肝轉移相關臨床病理因素研究.肝膽外科雜志, 2013, 21(4):284-287.
19.	Cihan S, Uncu D, Babacan NA, et al. Adjuvant modified FOLFOX-4 in patients with stageⅢrectum adenocarcinoma. Asian Pac J Cancer Prev, 2011, 12(4):967-970.
20.	張金山.現代腹部介入放射學.北京:科學出版社, 2000:83-85.
21.	龔光偉, 沈雄山, 羅麗, 等.大腸癌同時伴肝轉移67例臨床治療分析.腹部外科, 2010, 23(6):348-349.
22.	萬德森.腸腔灌注氟尿嘧啶后腸系膜靜脈和周圍靜脈血藥濃度測定-腸腔化療機制探討.癌癥, 1990, 9(3):189.
23.	何建苗, 蒲永東, 朱志東, 等.直腸癌根除術后髂內動脈加門靜脈置泵化療預防局部復發和肝轉移的研究.中華普通外科雜志, 2001, 16(10):586-587.
24.	Baccheai S, Pasqual E, Cagol PP. Epirubicin and its metabolites levels in experimental liver metastases after different administra-tionroutes. J Exp Clin Cancer Res, 2003, 22(4):184-185.
25.	夏術森, 王崇樹, 魏壽江, 等.胃癌根治術中區域動脈灌注化療的臨床毒副反應及病理觀察.中國普外基礎與臨床雜志, 2010, 17(1):17-217.

1. Jiang JK, Lan YT, Lin TC, et al. Primary vs. delayed resection for obstructive left-sided colorectal cancer:impact of surgery on patient outcome. Dis Colon Rectum, 2008, 51(3):306-311.
2. Chen HS, Sheen-Chen SM. Obstruction and perforation in colore-ctal adenocarcinoma:an analysis of prognosis and current trends. Surgery, 2000, 127(4):370-376.
3. Lee YM, Law WL, Chu KW, et al. Emergency surgery for obstructing colorectal cancers:a comparison between right-sided and left-sided lesions. J Am Coll Surg, 2001, 192 (6):719-725.
4. Huang TJ, Wang JY, Lee LW, et al. Emergency one-stage surgery for obstructing left-sided colorectal carcinomas. Kaohsiung J Med Sci, 2002, 18(7):323-328.
5. De Salvo GL, Gava C, Pucciarelli S, et al. Curative surgery for obstru-ction from primary left colorectal carcinoma:primary or staged resection? Cochrane Database Syst Rev, 2004, 19(2):CD002101.
6. Yang ZL, Wang L, Kang L, et al. Clinicopathologic Characteristics and Outcomes of Patients with Obstructive Colorectal Cancer. J Gastrointest Surg, 2011, 15(7):1213-1222.
7. 戴起寶, 蘭斌, 許東坡.門靜脈插管化療防治結直腸癌術后肝轉移.福建醫科大學學報, 2003, 37(4):426-427.
8. 胡曉平, 王小平, 鄒國英, 等.門靜脈插管化療預防結直腸癌術后肝轉移的效果.實用臨床醫學, 2011, 12(8):66-67.
9. Yu DS, Li Y, Huang XE, et al. Effect of portal vein chemotherapy on liver metastasis after surgical resection of colorectal cancer. Asian Pac J Cancer Prev, 2012, 13 (9):4699-4701.
10. 周輝, 吳纓, 牟洪超, 等.經門靜脈和肝動脈灌注化療治療不可切除的結直腸癌肝轉移的臨床研究.腫瘤學雜志, 2015, 25 (1):51-55.
11. 賴瑋婧, 汪曉東, 陳海燕, 等.梗阻型中下段直腸腸癌一期吻合手術的臨床效果.中國普外基礎與臨床雜志, 2009, 16(11):918-921.
12. 郝晉, 楊廷翰, 蒲怡, 等.梗阻型結直腸癌外科治療中運用快速流程的安全性.中國普外基礎與臨床雜志, 2010, 17(12):1314-1317.
13. 周際昌.實用腫瘤內科學.北京:人民衛生出版社, 1999:23-35.
14. 張思維, 雷正龍, 李光琳, 等.中國腫瘤登記地區2006年腫瘤發病和死亡資料分析.中國腫瘤, 2010, 19(6):356-365.
15. 陳顥, 張劍軍, 孟志強, 等.結直腸癌伴肝轉移9l例患者的多因素預后分析.腫瘤, 2008, 28(2):153-156.
16. Goos JA, Coupe VM, Diosdado B, et al. Aurora kinase A(AUR-KA)expression in colorectal cancer liver metastasis is associated with poor prognosis. Br J Cancer, 2013, 109(9):2445-2452.
17. 劉傳淵, 張森, 高楓, 等. Dukes' C期結直腸癌異時性肝轉移相關因素分析.中國腫瘤臨床, 2010, 37(6):313-316.
18. 王勝利, 何新陽.結直腸癌肝轉移相關臨床病理因素研究.肝膽外科雜志, 2013, 21(4):284-287.
19. Cihan S, Uncu D, Babacan NA, et al. Adjuvant modified FOLFOX-4 in patients with stageⅢrectum adenocarcinoma. Asian Pac J Cancer Prev, 2011, 12(4):967-970.
20. 張金山.現代腹部介入放射學.北京:科學出版社, 2000:83-85.
21. 龔光偉, 沈雄山, 羅麗, 等.大腸癌同時伴肝轉移67例臨床治療分析.腹部外科, 2010, 23(6):348-349.
22. 萬德森.腸腔灌注氟尿嘧啶后腸系膜靜脈和周圍靜脈血藥濃度測定-腸腔化療機制探討.癌癥, 1990, 9(3):189.
23. 何建苗, 蒲永東, 朱志東, 等.直腸癌根除術后髂內動脈加門靜脈置泵化療預防局部復發和肝轉移的研究.中華普通外科雜志, 2001, 16(10):586-587.
24. Baccheai S, Pasqual E, Cagol PP. Epirubicin and its metabolites levels in experimental liver metastases after different administra-tionroutes. J Exp Clin Cancer Res, 2003, 22(4):184-185.
25. 夏術森, 王崇樹, 魏壽江, 等.胃癌根治術中區域動脈灌注化療的臨床毒副反應及病理觀察.中國普外基礎與臨床雜志, 2010, 17(1):17-217.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect on Liver Metastases of Intraoperative and Postoperative Portal Vein Chemotherapy and Combined with FOLFOX4 regimen chemotherapy for Patients with Obstrutive Colorectal Cancer

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