Prognosis and risk factors after surgical treatment for colorectal cancer liver metastases
10.3760/cma.j.cn113884-20200421-00216
- VernacularTitle:结直肠癌肝转移手术治疗预后及影响因素分析
- Author:
Xiaoluan YAN
1
;
Kun WANG
;
Quan BAO
;
Hongwei WANG
;
Kemin JIN
;
Baocai XING
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所肝胆胰外一科 恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142
- From:
Chinese Journal of Hepatobiliary Surgery
2020;26(7):508-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the impact of surgical treatment on long-term survival in patients with colorectal cancer liver metastases, and to identify the associated risk factors.Methods:The clinical, pathological, and follow-up data were prospectively collected from 781 consecutive patients who underwent hepatic resection for colorectal liver metastases at Hepatopancreatobiliary Surgery Department Ⅰ, Peking Cancer Hospital from Jan 2000 to Nov 2018. There were 497 males and 284 females. The average age was 56.7 years (range 19 to 83 years). The tumor recurrence and survival outcomes on follow-up were analyzed. Survival curves were plotted using the Kplan-Meier mothod. Parametric survival analysis was used to identify predictors of cancer-specific survival.Results:The 1-, 3-, 5- and 10-year overall survival rates were 91.6%, 57.3%, 45.2% and 27.6%, respectively. The median survival was 46 months. The 1-, 3-, 5- and 10-year disease-free survival rates were 45.3%, 26.0%, 22.9%, and 19.5%, respectively. The median disease-free survival was 11 months. On multivariate analysis, 5 risk factors were found to be independent predictors of poor survival: RAS/BRAF gene mutation ( HR=1.650, 95% CI: 1.302-2.089), right-sided colonic primary ( HR=1.361, 95% CI: 1.151-1.667), node-positive primary ( HR=1.660, 95% CI: 1.284-2.146), largest hepatic tumor ≥3 cm ( HR=1.473, 95% CI: 1.157-1.874), and extrahepatic disease ( HR=1.610, 95% CI: 1.294-2.003). Conclusion:Surgery is the key to long-term survival for patients with liver metastases from colorectal cancer. Right colonic primary, RAS/BRAF gene mutation, primary lymph node metastasis, hepatic metastasis with a maximum diameter ≥3 cm and extrahepatic metastasis were factors associated with poor prognosis.
