Multiple factor analysis on the prognosis of colorectal cancer patients with liver metastases / 肿瘤

ABSTRACT

Objective:To investigate the clinicopathological factors affecting the prognosis of colorectal cancer patients with liver metastasis and how to select therapeutic method. Methods:The clinical records of 146 colorectal cancer patients with liver metastases who were admitted in Cancer Hospital of Guizhou Province from March 1997 to March 2007 were collected and made a retrospective analysis. The survival rate of the 146 patients was calculated by using life table method. Kaplan-Meier method and log-rank test were used for univariate analysis on clinicopathological features and therapeutic modalities. The multivariate analysis was performed by using COX regression model. The prognostic index (PI) of patients was calculated based on the result of multivariate analysis. The patients were classified into different risk groups according to PI value and the survival rate was compared between the different groups. RusultsThe overall 1-, 3-, and 5-year survival rates were 62.0%, 15.5%and 6.2%, respectively. Univariate analysis revealed that the following factors were related with the prognosis of colorectal cancer patients with liver metastasis. They included pathological classification, histological grade, serum CEA(carcinoembryonic antigen)level, primary tumor resection, local lymph node metastasis, number and size of liver metastases, distribution and initiation time of liver metastases, extrahepatic invasion, with or without surgery and che-motherapy for liver metastasis, and chemotherapeutic regimen selection. Multivariate analysis showed that the serum CEA level, extrahepatic metastasis, number and size of liver metastases, primary tumor resection, and chemotherapeutic regimen were independent prognostic factors for colorectal patients with liver metastasis.Conclusion:The therapeutic modality had an obvious effect on the prognosis of colorectal cancer with liver metastasis. Active treatment for primary tumor and metastatic lesions increased the survival rate of patients. Serum CEA levels, with or without extrahepatic metastases, and the number and size of liver metastases were prognostic factors. PI value could be used to predict the prognosis of colorectal cancer patients with liver metastasis.