结直肠癌肝转移患者的临床特征及与预后的关系

Clinical features of colorectal cancer patients with liver metastasis and their correlations with prognosis

目的探讨结直肠癌肝转移患者的临床特征及其与预后的关系。方法回顾性分析2018年9月至2021年1月就诊于西南医科大学附属医院消化内科、胃肠外科、肿瘤科的结直肠癌肝转移患者的临床资料。结果本组共纳入145例患者,原发病确诊时年龄不同、肝转移后是否化疗的患者肝转移后生存时间存在差异;初始分期不同、诊断初期是否行原发灶手术治疗、肝转移发生时间长短等因素对患者的总生存期存在影响(P<0.05)。多因素分析显示,仅诊断初期原发灶手术治疗是OS的独立危险因素(P<0.05)。结论结直肠癌肝转移患者多数为同时性肝转移。原发肿瘤确诊时年龄<60岁以及肝转移后行化疗的患者生存时间有显著延长;诊断初期原发灶手术治疗是OS的独立危险因素。

Objective To investigate the clinical features of colorectal cancer patients with liver metastasis and their correlations with prognosis.Methods Clinical medical records of colorectal cancer patients with liver metastasis admitted to departments of gastroenterology,gastrointestinal surgery and oncology in our hospital from September 2018 to January 2021 were retrospectively analyzed.Results There were 145 patients met the inclusion criteria.There were differences in the survival time in different ages at the time of diagnosis of the primary disease and whether patients undergoing chemotherapy after liver metastasis.The different initial stage,whether the primary tumor treated with surgery at the initial stage of diagnosis,and the length of time of the liver metastasis had an impact on the overall survival of patients(P<0.05).Multivariate analysis showed that only surgical treatment of the primary lesions at the beginning of diagnosis was an independent risk factor for overall survival(OS).Conclusion Most colorectal cancer patients have liver metastasis simultaneously.The survival time of patients is significantly prolonged when patients are younger than 60 years old at diagnosis of the primary tumor,and patients receive chemotherapy after liver metastasis.Surgical treatment of the primary tumor at the initial diagnosis is an independent risk factor for OS.