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.	戴起宝, 兰斌, 许东坡.门静脉插管化疗防治结直肠癌术后肝转移.福建医科大学学报, 2003, 37(4):426-427.
8.	胡晓平, 王小平, 邹国英, 等.门静脉插管化疗预防结直肠癌术后肝转移的效果.实用临床医学, 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.	周辉, 吴缨, 牟洪超, 等.经门静脉和肝动脉灌注化疗治疗不可切除的结直肠癌肝转移的临床研究.肿瘤学杂志, 2015, 25 (1):51-55.
11.	赖玮婧, 汪晓东, 陈海燕, 等.梗阻型中下段直肠肠癌一期吻合手术的临床效果.中国普外基础与临床杂志, 2009, 16(11):918-921.
12.	郝晋, 杨廷翰, 蒲怡, 等.梗阻型结直肠癌外科治疗中运用快速流程的安全性.中国普外基础与临床杂志, 2010, 17(12):1314-1317.
13.	周际昌.实用肿瘤内科学.北京:人民卫生出版社, 1999:23-35.
14.	张思维, 雷正龙, 李光琳, 等.中国肿瘤登记地区2006年肿瘤发病和死亡资料分析.中国肿瘤, 2010, 19(6):356-365.
15.	陈颢, 张剑军, 孟志强, 等.结直肠癌伴肝转移9l例患者的多因素预后分析.肿瘤, 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.	刘传渊, 张森, 高枫, 等. Dukes' C期结直肠癌异时性肝转移相关因素分析.中国肿瘤临床, 2010, 37(6):313-316.
18.	王胜利, 何新阳.结直肠癌肝转移相关临床病理因素研究.肝胆外科杂志, 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.	张金山.现代腹部介入放射学.北京:科学出版社, 2000:83-85.
21.	龚光伟, 沈雄山, 罗丽, 等.大肠癌同时伴肝转移67例临床治疗分析.腹部外科, 2010, 23(6):348-349.
22.	万德森.肠腔灌注氟尿嘧啶后肠系膜静脉和周围静脉血药浓度测定-肠腔化疗机制探讨.癌症, 1990, 9(3):189.
23.	何建苗, 蒲永东, 朱志东, 等.直肠癌根除术后髂内动脉加门静脉置泵化疗预防局部复发和肝转移的研究.中华普通外科杂志, 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.	夏术森, 王崇树, 魏寿江, 等.胃癌根治术中区域动脉灌注化疗的临床毒副反应及病理观察.中国普外基础与临床杂志, 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. 戴起宝, 兰斌, 许东坡.门静脉插管化疗防治结直肠癌术后肝转移.福建医科大学学报, 2003, 37(4):426-427.
8. 胡晓平, 王小平, 邹国英, 等.门静脉插管化疗预防结直肠癌术后肝转移的效果.实用临床医学, 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. 周辉, 吴缨, 牟洪超, 等.经门静脉和肝动脉灌注化疗治疗不可切除的结直肠癌肝转移的临床研究.肿瘤学杂志, 2015, 25 (1):51-55.
11. 赖玮婧, 汪晓东, 陈海燕, 等.梗阻型中下段直肠肠癌一期吻合手术的临床效果.中国普外基础与临床杂志, 2009, 16(11):918-921.
12. 郝晋, 杨廷翰, 蒲怡, 等.梗阻型结直肠癌外科治疗中运用快速流程的安全性.中国普外基础与临床杂志, 2010, 17(12):1314-1317.
13. 周际昌.实用肿瘤内科学.北京:人民卫生出版社, 1999:23-35.
14. 张思维, 雷正龙, 李光琳, 等.中国肿瘤登记地区2006年肿瘤发病和死亡资料分析.中国肿瘤, 2010, 19(6):356-365.
15. 陈颢, 张剑军, 孟志强, 等.结直肠癌伴肝转移9l例患者的多因素预后分析.肿瘤, 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. 刘传渊, 张森, 高枫, 等. Dukes' C期结直肠癌异时性肝转移相关因素分析.中国肿瘤临床, 2010, 37(6):313-316.
18. 王胜利, 何新阳.结直肠癌肝转移相关临床病理因素研究.肝胆外科杂志, 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. 张金山.现代腹部介入放射学.北京:科学出版社, 2000:83-85.
21. 龚光伟, 沈雄山, 罗丽, 等.大肠癌同时伴肝转移67例临床治疗分析.腹部外科, 2010, 23(6):348-349.
22. 万德森.肠腔灌注氟尿嘧啶后肠系膜静脉和周围静脉血药浓度测定-肠腔化疗机制探讨.癌症, 1990, 9(3):189.
23. 何建苗, 蒲永东, 朱志东, 等.直肠癌根除术后髂内动脉加门静脉置泵化疗预防局部复发和肝转移的研究.中华普通外科杂志, 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. 夏术森, 王崇树, 魏寿江, 等.胃癌根治术中区域动脉灌注化疗的临床毒副反应及病理观察.中国普外基础与临床杂志, 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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