摘要
OBJECTIVE To explore prognostic factors and treatmentchoices for colorectal cancer (CRC) patients with concurrent livermetastases (CLM).METHODS The data of the 122 CRC patients with CLM, whowere treated in our hospital from January 2000 to December 2005,were collected. Overall survival rate of the patients in our groupwas analyzed using Kaplan-Meier method, and the univariateand multivariate analyses of the 18 factors affecting the survivalrate, including clinicopathologic factors and treatment methods,were conducted using Log-rank test and Cox regression model(SPSS13.0).RESULTS The median survival time of the 122 patients withCRC was 13 months. The 1, 2, 3 and 5-year survival rate was52.46%, 24.59%, 12.30% and 3.28%, respectively. Univariateanalysis combined with Kaplan-Meier curve revealed that thefactors of prognosis included the size of the primary tumor, thelevels of differentiation, lymphatic status, cancerous ileus (CI),the number, size and distribution of liver metastases, extrahepaticinvolvement, the serum CEA level at diagnosis, treatmentmodality, the extent of primary resection, chemotherapeuticmodality and regimen. Multivariate analysis showed that CI,differentiation levels, serum CEA value at diagnosis and treatmentmodality were the independent prognostic factors of CRC patientswith CLM.CONCLUSION For the CRC patients with CLM, poordifferentiation of the tumor and CI, as well as a high CEAlevel indicate an unfavorable prognosis. Treatment choice is ofspecial significance in treating the CRC patients with CLM, soactive radical excision of the primary tumor and liver metastasisis strongly recommended in the CRC patients with hepaticmetastasis alone. Interventional chemotherapy has advantagescompared with the whole-body chemotherapy via peripheral vein,and the regimen of systemic chemotherapy containing oxaliplatinis preferred.
OBJECTIVE To explore prognostic factors and treatment choices for colorectal cancer （CRC） patients with concurrent liver metastases （CLM）. METHODS The data of the 122 CRC patients with CLM, who were treated in our hospital from January 2000 to December 2005, were collected. Overall survival rate of the patients in our group was analyzed using Kaplan-Meier method, and the univariate and multivariate analyses of the 18 factors affecting the survival rate, including clinicopathologic factors and treatment methods, were conducted using Log-rank test and Cox regression model （SPSS13.0）. RESULTS The median survival time of the 122 patients with CRC was 13 months. The 1, 2, 3 and 5-year survival rate was 52.46%, 24.59%, 12.30% and 3.28%, respectively. Univariate analysis combined with Kaplan-Meier curve revealed that the factors of prognosis included the size of the primary tumor, the levels of differentiation, lymphatic status, cancerous ileus （CI）, the number, size and distribution of liver metastases, extrahepatic involvement, the serum CEA level at diagnosis, treatment modality, the extent of primary resection, chemotherapeutic modality and regimen. Multivariate analysis showed that CI, differentiation levels, serum CEA value at diagnosis and treatment modality were the independent prognostic factors of CRC patients with CLM. CONCLUSION For the CRC patients with CLM, poor differentiation of the tumor and CI, as well as a high CEA level indicate an unfavorable prognosis. Treatment choice is of special significance in treating the CRC patients with CLM, so active radical excision of the primary tumor and liver metastasis is strongly recommended in the CRC patients with hepatic metastasis alone. Interventional chemotherapy has advantages compared with the whole-body chemotherapy via peripheral vein, and the regimen of systemic chemotherapy containing oxaliplatin is preferred.
关键词
结直肠癌
并行
预后
肝
colorectal cancer/primary, synchronous liver metastases, prognosis, multivariate analysis, univariate analysis.
