Analysis of prognosis of 122 colorectal cancer patients with concurrent liver metastasis

Abstract

OBJECTIVETo 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 aff ecting 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, diff erentiation levels, serum CEA value at diagnosis and treatment modality were the independent prognostic factors of CRC patients with CLM. CONCLUSIONFor 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.KEY WORDS: colorectal cancer/primary, synchronous liver metastases, prognosis, multivariate analysis, univariate analysis.

Factors that influence survival in colorectal cancer with synchronous distant metastasis

“…15 In recent studies involving CRC with liver metastases, CEA is still an independent factor influencing survival. 10,16 Resection of colorectal liver metastases in selected patients has evolved as the standard of care during the last 20 years.…”