M1分期细化对结直肠癌远处转移患者预后的影响

Effect of Subdividing M1 Stage on the Prognosis of Colorectal Cancer with Distant Metastasis

目的探讨M1分期细化对结直肠癌远处转移患者生存和预后的影响。方法随访80例结直肠癌远处转移患者,分析其转移部位、转移灶的数目、转移瘤的大小及其相应治疗方式等因素,对预后因素进行单因素及多因素分析。结果单因素Kaplan-Meier法分析与预后相关的因素(P<0.05)为7项,分别为分化程度越低,N分期高,CEA>5μg/L,CA199>35 U/m L,癌性梗阻,转移器官数目2个以上和异时性转移预后差。分化程度、CEA、N分期、癌性梗阻、转移器官数目、转移时间顺序是影响结直肠癌远处转移患者预后的独立预后因素。结论不同临床特征和治疗方式的结直肠癌远处转移患者的预后明显不同,根据其转移特征,进行M1分期细化,区分其中具有较好预后的患者,采用个体化治疗方法,有望通过积极治疗获得长期生存。

Objective To investigate the effect of subdividing M1 stage on the prognosis of colorectal cancer with distant metastasis. Methods 80 cases of colorectal cancer with distant metastasis were selected and sites of metastases,number of metastases,size of hepatic metastatic tumor and corresponding treatments were recorded and the relationship with prognosis was analyzed. Results Single factor Kaplan-Meier analysis showed that there were 7 related prognostic factors. Patients with low differentiation degree,high N stage,CEA > 5 μg / L,CA199 > 35 U / m L,cancerous obstruction,more than 2 organs metastases and metachronous metastases had worse prognosis. Differentiation degree,CEA,N stage,cancerous obstruction,number of metastases,chronological order of metastases were independent prognostic factors of colorectal cancer with distant metastasis. Conclusion Colorectal cancer with distant metastasis with different clinical features and treatments have different prognosis. Subdividing M1 stage according to metastases and personalized treatment can prolong patients’ survival.