Boysen Anders Kindberg, Spindler Karen-Lise, Høyer Morten, Mortensen Frank Viborg, Christensen Thomas Decker, Farkas Dóra Kormendine, Ording Anne Gulbech
Department of Oncology, Aarhus University Hospital, Aarhus, C 8000, Denmark.
Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, C 8000, Denmark.
Int J Cancer. 2018 Dec 15;143(12):3218-3226. doi: 10.1002/ijc.31626. Epub 2018 Oct 22.
About 10-20% of patients with metastatic colorectal cancer (mCRC) are candidates for metastasis directed therapies such as surgical resection, ablation and stereotactic radiotherapy. We examined the temporal changes in use of metastasis directed therapies and established prognostic factors for survival in a nationwide cohort study. The Danish nationwide medical registries were used to retrieve data on treatment for liver and/or lung metastasis in patients with metastatic colorectal cancer in the period 2000-2013. Overall survival through 2014 was calculated from the time of treatment of metastases by Kaplan-Meier method and mortality between groups was assessed using Cox regression. We report 2,912 patients undergoing a total of 3,602 procedures with an increased use of all modalities during 14 calendar years. Median survival was 3.7 years (interquartile range (IQR) 2.0-9.7 years). In the multivariate analysis, the nodal stage of the primary tumor had the most pronounced association with survival with a hazard ratio for mortality of 1.56 (95% CI: 1.33-1.83) for N2 stage with reference to N0. Furthermore, female gender, age, comorbidity, surgical treatment, administration of chemotherapy, and left-sided primary tumors were associated with improved prognosis in the multivariate analysis.
约10%-20%的转移性结直肠癌（mCRC）患者适合接受转移灶定向治疗，如手术切除、消融和立体定向放疗。在一项全国性队列研究中，我们研究了转移灶定向治疗使用情况的时间变化，并确定了生存的预后因素。利用丹麦全国医疗登记系统检索2000年至2013年期间转移性结直肠癌患者肝和/或肺转移治疗的数据。通过Kaplan-Meier方法从转移灶治疗时间计算至2014年的总生存期，并使用Cox回归评估组间死亡率。我们报告了2912例患者共接受3602次治疗，在14个日历年中所有治疗方式的使用均有所增加。中位生存期为3.7年（四分位间距（IQR）2.0-9.7年）。在多变量分析中，原发肿瘤的淋巴结分期与生存的关联最为显著，N2期相对于N0期的死亡风险比为1.56（95%CI：1.33-1.83）。此外，在多变量分析中，女性、年龄、合并症、手术治疗、化疗给药以及左侧原发肿瘤与预后改善相关。
