Analysis of treatment and prognostic factors in colorectal cancer liver metastasis
10.3760/cma.j.issn.1671-0274.2015.09.019
- VernacularTitle:结直肠癌肝转移的治疗及预后因素分析
- Author:
Tianyu QIAO
1
;
Yongpeng XU
;
Xu GUAN
;
Dazhuang MIAO
;
Xishan WANG
Author Information
1. 150086,哈尔滨医科大学附属第二医院结直肠肿瘤外科 哈尔滨医科大学大肠癌研究所
- Keywords:
Colorectal neoplasms;
Liver metastasis;
Treatment;
Prognostic factors
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(9):930-934
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prognostic factors of colorectal cancer patients with liver metastasis in order to provide reference for clinical practice. Methods Clinicopathological and follow-up data of 264 cases of colorectal liver metastasis in our department from January 1997 to January 2012 were analyzed retrospectively. Among these 264 patients , 217 underwent primary colorectal cancer resection, 33 underwent combined resection of primary colorectal lesion plus liver metastasis, and 14 received stoma creation alone. Besides, 197 patients received adjuvant chemotherapy, 14 received adjuvant radiotherapy, and 42 underwent interventional treatment. Clinicopathological features and treatment scheme affecting prognosis were analyzed and prognostic stratification analysis was performed according to emergence time of liver metastasis (synchronous or metachronous). Results Of 264 patients, 1-, 3-, and 5-year overall survival rates were 77.0%, 31.7%, and 14.0%; median survival time was 25 months; 1-, 3-, and 5-year survival rates of synchronous colorectal liver metastasis were 68.8%, 22.3%, and 7.7%; 1-, 3-, and 5-year survival rates of metochronous colorectal liver metastasis were 95.8%, 49.0%, and 21.3%, whose difference was statistically significant (P<0.05). Multivariate analysis showed that primary tumor differentiation, CEA level, adjuvant chemotherapy, and radical resection were independent prognostic factors of colorectal cancer patients with liver metastasis (all P<0.05), while primary tumor differentiation, CEA level, and radical resection were independent prognostic factors of synchronous liver metastasis (all P<0.05), and primary tumor location and CEA level were independent prognostic factors of metachronous liver metastasis (all P<0.05). Conclusions Radical operation and adjuvant chemotherapy should be emphasized for colorectal liver metastasis, especially for synchronous colorectal liver metastasis. Simple resection of primary tumor can not improve the overall survival of patients with colorectal liver metastasis.
