Improved survival in synchronous liver metastases with colorectal cancer is associated with surgical strategy

doi:10.3877/cma.j.issn.2095-3224.2021.02.013

Abstract

Abstract:

Objective

The optimization of chemotherapy and surgical strategies has significantly improved the survival of patients with colorectal cancer liver metastases. This study intends to use the data from the National Cancer Center of China to describe the survival rate of synchronous liver metastases with colorectal cancer patients and explore the relationship with treatment strategies.

Methods

A retrospective analysis of the clinical data of patients with synchronous liver metastases of colorectal cancer diagnosed and treated at the National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from January 2010 to February 2018. According to the year of diagnosis, the patent divided into four groups including 2010 to 2011, 2012 to 2013, 2014 to 2015 and 2016 to 2017. The cancer-specific survival and surgical strategy differences were analyzed.

Results

A total of 1 286 patients with colorectal cancer were included in this study, and the median survival time increased from 20 months in 2010-2011 to 33 months in 2016-2017. The 3-year cancer-specific survival rate increased from 23.0% to 45.3%. The 5-year cancer-specific survival rate increased from 9.5% to 35.2%. The survival of patients receiving primary tumor resection and liver metastasis local treatment was better than that of chemotherapy alone group, primary tumor resection group and liver metastasis local treatment group.

Conclusion

This population-based study has shown the cancer-specific survival of patients has been significantly improved in synchronous liver metastases of colorectal cancer patient. The proportion of receiving surgical strategies increased is related to better survival.

Key words: Colorectal neoplasms, Liver metastases, Surgical strategy, Survival time

Xiaolong Ma, Xu Guan, Runkun Yang, Zhixun Zhao, Enrui Liu, Haiyang Huang, Haipeng Chen, Zheng Liu, Zheng Jiang, Yinggang Chen, Xishan Wang. Improved survival in synchronous liver metastases with colorectal cancer is associated with surgical strategy[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(02): 194-200.

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References 40

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变量	2010~2011 （n=283）	2012~2013 （n=256）	2014~2015 （n=316）	2016~2017 （n=431）	χ²值	P值
年龄（岁）					1.59	0.66
≤60	179（63.3）	161（62.9）	192（60.8）	255（59.2）
＞60	104（36.7）	95（37.1）	124（39.2）	176（40.8）
性别					13.08	0.005
女	128（45.2）	92（35.9）	100（31.6）	150（34.8）
男	155（54.8）	164（64.1）	216（68.4）	281（65.2）
原发肿瘤部位					2.24	0.90
右半结肠	72（25.4）	61（23.8）	83（26.3）	106（24.6）
左半结肠	106（37.5）	101（35.7）	131（41.5）	171（39.7）
直肠	105（37.1）	94（36.7）	102（32.3）	154（35.7）
CEA水平					0.29	0.96
正常	51（18）	45（17.6）	52（16.4）	76（17.6）
异常	232（82）	211（82.4）	264（83.6）	355（82.4）
组织学分级					1.53	0.68
中/高分化	220（77.7）	201（78.5%）	249（78.8）	325（75.4）
低/未分化	63（22.3）	55（21.5）	67（21.2）	106（24.6）
病理类型					2.64	0.45
腺癌	269（95.1）	244（95.3）	306（96.8）	418（97）
黏液腺癌	14（4.9）	12（4.7）	10（3.2）	13（3）
M1分期					4.05	0.67
a	209（73.9）	191（74.6）	233（73.7）	329（76.3）
b	55（19.4）	51（19.9）	61（19.3）	85（19.7）
c	19（6.7）	14（5.5）	22（7）	17（3.9）

变量	2010~2011 （n=283）	2012~2013 （n=256）	2014~2015 （n=316）	2016~2017 （n=431）	χ²值	P值
年龄（岁）					1.59	0.66
≤60	179（63.3）	161（62.9）	192（60.8）	255（59.2）
＞60	104（36.7）	95（37.1）	124（39.2）	176（40.8）
性别					13.08	0.005
女	128（45.2）	92（35.9）	100（31.6）	150（34.8）
男	155（54.8）	164（64.1）	216（68.4）	281（65.2）
原发肿瘤部位					2.24	0.90
右半结肠	72（25.4）	61（23.8）	83（26.3）	106（24.6）
左半结肠	106（37.5）	101（35.7）	131（41.5）	171（39.7）
直肠	105（37.1）	94（36.7）	102（32.3）	154（35.7）
CEA水平					0.29	0.96
正常	51（18）	45（17.6）	52（16.4）	76（17.6）
异常	232（82）	211（82.4）	264（83.6）	355（82.4）
组织学分级					1.53	0.68
中/高分化	220（77.7）	201（78.5%）	249（78.8）	325（75.4）
低/未分化	63（22.3）	55（21.5）	67（21.2）	106（24.6）
病理类型					2.64	0.45
腺癌	269（95.1）	244（95.3）	306（96.8）	418（97）
黏液腺癌	14（4.9）	12（4.7）	10（3.2）	13（3）
M1分期					4.05	0.67
a	209（73.9）	191（74.6）	233（73.7）	329（76.3）
b	55（19.4）	51（19.9）	61（19.3）	85（19.7）
c	19（6.7）	14（5.5）	22（7）	17（3.9）

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