oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2018-17-2-60-70oncotomsk-717Research ArticleОБЗОРЫREVIEWSФАКТОРЫ ПРОГНОЗА В ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ МЕТАСТАЗОВ КОЛОРЕКТАЛЬНОГО РАКА В ЛЕГКИХPROGNOSTIC FACTORS IN THE TREATMENT OF LUNG METASTASES FROM COLORECTAL CANCERАхмедовБ. Б.AkhmedovB. B.

кандидат медицинских наук, старший научный сотрудник торакального отделения торакоабдоминального отдела, ФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России (г. Москва, Россия)

SPIN-код: 9984-5890

AuthorID: 899688

MD, PhD, Senior Researcher, Department of Thoracic and Abdominal Surgery, N.N. Blokhin National Medical Research Center of Oncology (Moscow, Russia)

abb_onc@mail.ruДавыдовМ. М.DavydovM. M.

доктор медицинских наук, член-корреспондент РАН, заведующий торакальным отделением торако-абдоминального отдела, ФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России (г. Москва, Россия)

AuthorID: 555607

MD, DSc, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Thoracic and Abdominal Surgery, N.N. Blokhin National Medical Research Center of Oncology (Moscow, Russia)

ФедянинМ. Ю.FedyaninM. Yu.

доктор медицинских наук, старший научный сотрудник отделения клинической фармакологии и химиотерапии, ФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России (г. Москва, Россия)

SPIN-код: 4381-5628

MD, DSc, Senior Researcher, Department of Clinical Pharmacology and Chemotherapy, N.N. Blokhin National Medical Research Center of Oncology (Moscow, Russia)

fedianinmu@mail.ruАлиевВ. А.AlievV. A.

доктор медицинских наук, старший научный сотрудник отделения колопроктологии, ФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России (г. Москва, Россия)

AuthorID: 520863

MD, DSc, Senior Researcher, Department of Coloproctology and Chemotherapy, N.N. Blokhin National Medical Research Center of Oncology (Moscow, Russia)

afandi@inbox.ruГордеевС. С.GordeevS. S.

кандидат медицинских наук, старший научный сотрудник отделения колопроктологии, ФГБУ «Национальный медицинский исследовательский центр им. Н.Н. Блохина» Минздрава России (г. Москва, Россия)

SPIN-код: 6577-5540

AuthorID: 841348

MD, PhD, Department of Coloproctology and Chemotherapy, N.N. Blokhin National Medical Research Center of Oncology (Moscow, Russia)

ДадыевИ. А.DadyevI. A.

аспирант кафедры онкологии ФГБОУ ВО Московский государственный медико-стоматологический университет имени А.И. Евдокимова Министерства здравоохранения России (г. Москва, Россия)

Postgraduate, A.E. Evdokimov Moscow State University of Medicine and Dentistry (Moscow, Russia)

islamik_07@mail.ruФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава России, г. МоскваРоссияN.N. Blokhin National Medical Research Center of Oncology, MoscowRussian FederationФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава России, г. Москва; Московский государственный медико-стоматологический университет им. А.И. Евдокимова, г. МоскваРоссияN.N. Blokhin National Medical Research Center of Oncology, Moscow; A.E. Evdokimov Moscow State University of Medicine and Dentistry, MoscowRussian Federation2018080520181726070Copyright © Ахмедов Б.Б., Давыдов М.М., Федянин М.Ю., Алиев В.А., Гордеев С.С., Дадыев И.А., 20182018Ахмедов Б.Б., Давыдов М.М., Федянин М.Ю., Алиев В.А., Гордеев С.С., Дадыев И.А.Akhmedov B.B., Davydov M.M., Fedyanin M.Y., Aliev V.A., Gordeev S.S., Dadyev I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/717

Основываясь на данных мировой медицинской литературы и результатах отечественных исследователей, можно сделать вывод, что достоверно влияют на прогноз выживаемости больных колоректальным раком с метастатическим поражением легких радикальность выполненной операции, количество метастазов и величина DFI (интервал с момента излечения первичной опухоли до появления легочных метастазов). Поражение внутригрудных лимфатических узлов в сочетании с легочными метастазами, повышение уровня РЭА >10 нг/мл считаются крайне неблагоприятными прогностическими фактороми. В изученных нами статьях размер первичной опухоли, одностороннее или двустороннее распределение легочных метастазов не являлись прогностическими факторами выживаемости, однако некоторые авторы считают двустороннее поражение и распространение первичной опухоли T3–4 прогностически неблагоприятными признаками. Ключевыми факторами для проведения хирургического лечения легочных метастазов являются функциональная переносимость операции, выполнение радикального объема вмешательства, отсутствие других проявлений заболевания.

 

Based on the results of worldwide clinical studies, survival of colorectal cancer patients with lung metastases is significantly influenced by curative resection, number of metastases and disease free interval. Intrathoracic lymph node metastases in combination with pulmonary metastases as well as the CEA level of greater than 10ng/ml are found to be the most unfavorable prognostic factors. Most studies have found no significant relationship between survival and the size of the primary tumor and unilateral/bilateral distribution of pulmonary metastases. However, some authors consider that bilateral metastasis and T3-4 tumors are unfavorable prognostic factors. The key factors for surgical treatment of pulmonary metastases are the feasibility of performing curative resection and the absence of other manifestations of the disease.

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The authors declare that there are no conflicts of interest present.