150例转移性结直肠癌预后因素分析

An Analysis of Prognostic Factors for 150 Patients with Metastatic Colorectal Cancer

[目的]回顾性分析转移性结直肠癌(mCRC)的临床特征和治疗方法对m CRC患者预后的影响,为临床治疗决策提供循证依据。[方法]对黄山市人民医院肿瘤科2014年9月至2019年12月期间收治的150例mCRC患者的临床特征、治疗方法与患者总生存之间的关系进行单因素和多因素回归分析。[结果] 150例mCRC患者中位总生存期(MST)为24.8个月。单因素分析显示,M分期、CA199、局部治疗、西妥昔单抗或贝伐珠单抗、免疫治疗为mCRC生存影响因素(P<0.05)。根治性局部治疗组(24例)、姑息性局部治疗组(66例)、无局部治疗组(60例)的MST分别为未达到、24.4个月和14.5个月(P=0.00);西妥昔单抗或贝伐珠单抗使用组(83例)、未使用组(67例)的MST分别为34.8个月和23.3个月(P=0.03)。多因素分析显示,M分期、CA199、局部治疗、西妥昔单抗或贝伐珠单抗是影响mCRC生存的独立影响因素。[结论]影响mCRC生存的主要治疗因素是局部治疗和大分子靶向药物,多学科综合诊治和优化的全程管理是改善预后的关键。

[Objective] To retrospectively analyze the influence of clinical characteristics and all treatments on the prognosis of metastatic colorectal cancer(m CRC),so as to provide evidence-based basis for the clinical treatment decisions of m CRC. [Methods] The relationship between clinical characteristics,treatment methods with overall survival of 150 patients with m CRC in Oncology Department of Huangshan People’s Hospital,from September 2014 to December 2019 was analyzed by univariate and multivariate regression analysis. [Results] The median survival time(MST) of 150 patients with m CRC was 24.8 months. Univariate analysis showed that M stage,CA199 at the time of diagnosis,local treatment,cetuximab or bevacizumab and immunotherapy were influencing factors for survival of m CRC(P<0.05). The MST of radical local treatment group(24 cases),palliative local treatment group(66 cases) and no local treatment group(60 cases) were not reached,24.4 months and 14.5 months,respectively(P =0.00). The MST was 34.8 months in the cetuximab or bevacizumab group(83 cases) and 23.3 months in the non-use group(67 cases)(P=0.03). Multivariate analysis showed that M stage,CA199,local treatment and cetuximab or bevacizumab were independent factors affecting the survival of m CRC. [Conclusion] Local therapy and macromolecular targeted drugs are the main therapeutic factors affecting the survival of m CRC. Multidisciplinary comprehensive treatment and optimal whole-course management are the key factors to improve the prognosis.