Prognostic Analysis Of 300 Patients With Colorectal Liver Metastases

Objictive:To analyse the clinical characteristics,efficacy of treatment and potential prognostic factors of patients with colorectal liver metastases.Methods:Records of 300 patients with colorectal liver metastases treated at Cancer Institute and Hospital of Chinese Academy of Medical Sciences from Jan.2002 to Dec.2005 were review.Retrospective analysis of clinical characteristics,efficacy of treatment and survival were statistically carried out by SPSS 13.0.Reeult:The MSR time of patients was 18 months.Univariate analysis reveal that performance status(KPS),histological grading,primary tumor,N status, Lymphovascular invasion,stage at diagnosis,the number,size and distribution of liver metastases,accompanied other metastases,primary site and liver metastases resection, treatment modality after liver metastases,response to first-line therapy were prognostic factors.Multivariate analysis showed that KPS,Lymphovascular invasion, the number and size of liver metastases,liver metastases resection,treatment modality after liver metastases,response to first-line therapy were independently prognostic factors of colorectal liver metastases.The median survival of recurrence(MSR) was longer in patients with complete resection of colorectal liver metastases than insufficient resection and no resection(48m,19m and 18m,P=0.000).Systemic chemotherapy plus regional therapy demonstrated a superior survival for patients with unresectable liver metastases,compared with chemotherapy alone and regional therapy alone,the MSR time was 23m,21m and 15m(P=0.000) respectively.In first-line chemotherapy,modern chemotherapy with Oxaliplatin-based regimen or irinotecon-based regimen showed moderately longer treatment to progression(TTP) and MSR compared with no Oxaliplatin or irinotecon treatment,the median TTP was 6m vs.4m(P=0.054),the MSR was 21m vs.19m(P=0.69).The MSR were similar with oxaliplatin-based combinations and irinotecon-based combinations(21 m vs.18m, P=0.925).The MSR were similar with every 2 weeks or every 3 weeks in oxaliplatin-based combinations and irinotecon-based combinations(21.5m vs.20.5m, P=0.268;22m vs.16.5m,P=0.248).Conclusion:KPS,Lymphovascular invasion,the number and size of liver metastases,liver metastases resection,treatment modality after liver metastases,response to first-line therapy were independently prognostic factors of colorectal liver metastases.Primary tumor and liver metastases resection in resectable patients was optimal selection.The patients with unresectable disease could receive systemic chemotherapy plus regional treatment.Modern chemotherapy including oxaliplatin-based regimen or irinotecon-based regimen was received as first-line therapy either every two weeks or three weeks.