Effects of primary location of colorectal cancer on surgical outcome of liver metastases
10.3760/cma.j.cn341190-20221101-00870
- VernacularTitle:结直肠癌原发位置对肝脏转移瘤手术效果的影响
- Author:
Shigang PANG
1
;
Hongbo HAN
;
Tianhua GUO
Author Information
1. 滨州市中心医院胃肠外科，滨州 251700
- Keywords:
Colorectal neoplasms;
Liver neoplasms;
Neoplasm metastasis;
Recurrence;
Metastasectomy;
D-dimer;
Albumin;
Chemotherapy,adjuvant;
Risk assessment
- From:
Chinese Journal of Primary Medicine and Pharmacy
2023;30(7):1028-1033
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effects of the primary location of colorectal cancer on the surgical outcome of liver metastases.Methods:A cross-sectional study was conducted on 178 patients with liver metastases from colorectal cancer admitted to Binzhou Central Hospital from January 2012 to January 2022. According to whether the patients had recurrence after surgery, they were divided into a recurrence group ( n = 88) and a control group ( n = 90). The general and clinical data were compared between the two groups. Logistic multivariate analysis of the factors with statistical significance was further performed to identify the risk factors of postoperative recurrence of liver metastases from colorectal cancer after surgery. The correlation between the primary location of colorectal cancer and each risk factor was analyzed. The recurrence of colorectal cancer was compared anong patients with different primary locations of colorectal cancer at 12 months after surgery. Results:Primary location at the right colon [55.68% (49/88), lymph node metastasis [92.05% (81/88)], D-dimer ≥ 180 μ g/L, albumin < 29 g/L, ineffective/no neoadjuvant chemotherapy [43.18% (33/38)], and high-risk clinical risk score [53.41% (47/88)] were risk factors for postoperative recurrence of liver metastases from colorectal cancer after surgery ( P = 0.024, 0.019, 0.001, 0.028, < 0.001, 0.001). The primary location of colorectal cancer was positively correlated with lymph node metastasis, D-dimer, and clinical risk score ( P = 0.043, 0.046, 0.030), and negatively correlated with albumin and the efficacy of neoadjuvant chemotherapy ( P = 0.004, 0.033). In 178 patients, the recurrence rate of liver metastases from colorectal cancer at 3 months [53.57% (15/70)], 6 months [55.17% (32/70)], and 12 months [55.68% (49/70)] was significantly higher in the right colon compared with the left colon [32.14% (9/40), 24.14% (14/40), 26.14% (23/40) and the rectum [14.29% (4/68), 20.69% (12/68), 18.18% (16/68)] ( χ2= 4.73, 7.85, 6.27, all P < 0.05). Conclusion:Right colon, lymph node metastasis, D-dimer, albumin, neoadjuvant chemotherapy efficacy, and clinical risk score are the risk factors for postoperative recurrence of liver metastases from colorectal cancer. Patients with the primary location at the right colon have a higher postoperative recurrence rate.
