Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2012 Aug;75(8):370-5. doi: 10.1016/j.jcma.2012.03.008. Epub 2012 Jul 24.
Treatments for the purposes of curing or more effectively managing metastatic colorectal cancer (CRC) are evolving. Our study focused on patients with primary CRC with synchronous distant metastasis, and we analyzed the factors influencing patient survival.
Data review was conducted retrospectively. Clinicopathological parameters included age, sex, site of primary cancer, tumor cell differentiation, number of liver metastasis, presence of extrahepatic metastasis, treatment of liver metastasis, pre-treatment carcinoembryonic antigen (CEA) level, status of treatment response, salvage treatment and survival.
A total of 420 patients were identified and considered for our study. Of those, 275 patients (65.4%) had liver-only metastasis, 100 patients (23.8%) had concomitant lung metastasis, and 40 patients (9.5%) had other metastases. Additionally, 145 patients (34.5%) had liver-directed treatment including surgical resection (28.5%), radiofrequency ablation (RFA) (10.6%) and transcatheter arterial chemoembolization (TAE) (1.2%). There were 80 patients (19%) with CEA levels < 10, 135 patients (32.1%) with CEA 10-100, and 165 patients (39.2%) with CEA > 100. There were 200 patients (47.6%) who had received chemotherapy, 130 patients (30.9%) with target therapy, and 40 patients (9.5%) who had not undergone any salvage treatment. Three significant factors were identified, including treatment of liver metastasis (p=0.027), pre-treatment CEA (p=0.04), and salvage treatment (p=0.005).
We demonstrated three factors influencing patient survival including treatment of liver metastasis, pre-treatment CEA level, and salvage treatment. Aggressive treatment of liver metastasis including surgical resection or RFA combined with chemotherapeutic agents appear to provide an increased rate of survival to patients.
治疗转移性结直肠癌（CRC）的目的是治愈或更有效地治疗。我们的研究集中在原发性 CRC 伴同步远处转移的患者，分析影响患者生存的因素。
回顾性数据分析。临床病理参数包括年龄、性别、原发癌部位、肿瘤细胞分化程度、肝转移数量、肝外转移存在、肝转移治疗、治疗前癌胚抗原（CEA）水平、治疗反应状态、挽救治疗和生存。
共纳入 420 例患者进行研究。其中，275 例（65.4%）患者仅有肝转移，100 例（23.8%）患者同时伴有肺转移，40 例（9.5%）患者有其他转移。此外，145 例（34.5%）患者进行了肝定向治疗，包括手术切除（28.5%）、射频消融（RFA）（10.6%）和经导管动脉化疗栓塞（TAE）（1.2%）。CEA<10 的有 80 例（19%），CEA 为 10-100 的有 135 例（32.1%），CEA>100 的有 165 例（39.2%）。200 例（47.6%）患者接受了化疗，130 例（30.9%）患者接受了靶向治疗，40 例（9.5%）患者未接受任何挽救治疗。有三个显著因素，包括肝转移治疗（p=0.027）、治疗前 CEA（p=0.04）和挽救治疗（p=0.005）。
我们发现影响患者生存的三个因素包括肝转移治疗、治疗前 CEA 水平和挽救治疗。包括手术切除或 RFA 联合化疗药物在内的肝转移积极治疗似乎为患者提供了更高的生存率。
