The Evaluation Of Efficacy And Prognostic Factors For Colorectal Liver Metastases Treated With Transcatheter Arterial Chemoembolization

ObjectivesColorectal cancer, easily metastasis to liver, is one of the most popular digestive system malignant tumors. Liver metastasis is one of the most important clinical prognostic factors. Only 10%-20% patients had chance to accept metastatic tumor resection, although operation is the curative treatment. Transcatheter arterial chemoembolization (TACE) therapy is important in treating liver tumor and it has been extensively applied to treat liver metastatic colorectal cancer. The aim of this study is to evaluate the therapeutic efficacy and to identify the prognostic factors of TACE in the patients suffering from colorectal liver metastases (CRLM).Materials and MethodsThe clinical data of 183 patients with unresectable CRLM treated with TACE were retrospectively reviewed. Clinical characters such as gender, age, original tumor location, synchronous or metachronous liver metastases, extrahepatic metastases, the distribution of liver metastases, metastatic tumor number and size, baseline CEA and CA199 level, and therapy factors such as primary tumor resection, TACE times, tumor blood supply, tumor lipidol deposit, chemotherapy, regional therapy and phaseâ…¡resection were included in the analysis. Univariate survival analysis of Kaplan-Meier and multivariate survival analysis of Cox regression were used to evaluate the prognostic factors.Results1. The median survival time was 22 months, and the 0.5-,1-,2-,3-,5-year survival rates were 93.9%,81.1%,39.8%,18.2%,3.9%, respectively.2. Univariate analysis showed that the following factors were related with the prognosis of the CRLM patients who had undergone TACE:gender, extrahepatic metastases, the distribution of liver metastases, metastatic tumor size, baseline CEA and CA199 level, TACE times, primary tumor resection, regional therapy and phaseâ…¡resection. 3. Multivariate analysis indicated some independent prognostic factors for the CRLM patients after TACE treatment:tumor located more than one lobe of the liver, elevated CEA level and CA199 level were risk factors for overall survival, and females, more times of TACE, combined with regional therapy and received phase II resection related to good survival.ConclusionsTranscatheter arterial chemoembolization is an effective therapy for unresectable colorectal liver metastases. Patients with tumor spread more than one liver lobe, high CEA and CA199 level would suffer poor prognosis. Females, patients received more times of TACE, combined with regional therapy and received phaseâ…¡resection would have good survival.