Analysis Of The Relationgship Between Different Treatment Modes And Prognosis Of Liver Metastatic Of Colon Cancer

Objective:The PFS rate and OS rate of different treatment modes of newly diagnosed liver metastatic colon cancer were retrospectively analyzed to explore t he correlation between different treatment modes and prognosis of newly diagnos ed liver metastatic colon cancer,so as to provide basis for the selection of treatm ent mode of newly diagnosed liver metastatic colon cancer.Method:A retrospective analysis of 149 patients with newly diagnosed liver metastatic colon cancer from the First Affiliated Hospital of Dalian Medical Univ ersity from January 2013 to January 2017,including 116 patients with left colon cancer and 33 patients with right colon cancer.According to the different treatme nt modes of patients,they were divided into group A:after conversion therapy,MD T was used to evaluate the feasible surgical treatment,and the patients were treat ed at the appropriate time,that is,the conversion treatment was performed in the s equential operation group;Group B:the MDT assessment was feasible surgical tre atment after the conversion treatment,but the patient did not undergo surgery,that is,the conversion treatment was successful but did not undergo surgery.Group C:the patient had complications such as intestinal perforation,hemorrhage,obstruction,and the patient underwent surgery to remove the complications and then undergo chemotherapy.There were 37 patients in group A,54 patients in group B,and 58 patients in group C.According to the condition and survival status of each gro up of patients,the 2-year PFS rate and 2-year OS rate of each group were analy zed.Using SPSS 21.0 system,the balance of general data between groups was test ed by?~2test,the survival rate was compared by Kaplan-Meier method and the s urvival curve was drawn.The single factor analysis was performed by?~2test,and the statistically significant factors were further analyzed.Multivariate analysis was performed by binary logistic regression.P<0.05 was considered statistically signifi cant.Consequence:1.There were 37 patients in group A(transformation therapy sequential surge ry group),including 32 cases of left colon cancer and 5 cases of right colon can cer.At the end of follow-up,3 patients did not progress and 15 patients did not r each the overall survival time.The 2-year PFS rate was 13.5%,the median progres sion-free survival time was 16 months,the 2-year OS rate was 89.2%,and the me dian overall survival time was 34 months.2.There were 54 patients in group B(not in the operation group after succe ssful conversion therapy),40 patients with left colon cancer and 14 patients with right colon cancer.At the end of the follow-up,all patients showed progression an d 5 patients did not reach the overall survival time.The 2-year PFS rate was 5.6%,the median progression-free survival time was 7 months,the 2-year OS rate w as 50.0%,and the median overall survival time was 23.5 months.3.There were 58 patients in group C(surgical sequential chemotherapy grou p),including 44 cases of left colon cancer and 14 cases of right colon cancer.At the end of follow-up,2 patients did not progress and 14 patients did not reach th e total survival time.The 2-year PFS rate was 13.8%,the median progression-free survival time was 7 months,the 2-year OS rate was 70.7%,and the median overal l survival time was 28.5 months.4.Comparison of progression-free survival between groups by Kaplan-Meier method showed that there was a statistically significant difference in progression-free survival between the three groups,P=0.003;further comparison between groups:between group A(transformation therapy sequential surgery group)and group B(not in the operation group after successful conversion therapy),there was signific ant difference in progression-free survival,P=0.000;no difference in progression-fre e survival between group A(transformation therapy sequential surgery group)and group C(surgical sequential chemotherapy group),P=0.058;there was no statis tically significant difference in progression-free survival between group B(no sur gery after successful conversion therapy)and group C(surgical sequential chemot herapy group),P=0.174.5.The Kaplan-Meier method was used to compare the total survival between the groups.The total survival difference among the three groups was statistically significant,P=0.000.Further comparison between groups:between group A(transfor mation therapy sequential surgery group)and group B(not in the operation grou p after successful conversion therapy),there was a statistically significant differenc e in overall survival,P=0.000;there was no significant difference in the overall s urvival between group A(transformation sequential surgery group)and group C(surgical sequential chemotherapy group),P=0.078.There was a statistically signific ant difference in the overall survival of the group B(not in the surgery group aft er successful conversion therapy)and group C(surgical sequential chemotherapy g roup),P=0.001.6.Univariate analysis of each group by?~2test showed that the single factor results of group A:CRS>2 points were the factors affecting progression-free surv ival(P=0.027)and overall survival(P=0.022).Single factor results of group B:nu mber of metastases>1 were factors influencing progression-free survival in the g roup,P=0.009;number of metastases>1(P=0.040),diameter of metastases>5cm(P=0.028),CRS>2 points(P=0.006)is the factors that affects the overall survival of th e group.Single factor outcomes of group C:number of metastases>1(P=0.038),d iameter of metastases>5cm(P=0.017),and CRS>2(P=0.004)were factors influen cing progression-free survival in this group;The number of metastasis>1(P=0.018),the diameter of the metastases>5cm(P=0.001),and the CRS>2 points(P=0.000)were the factors affecting the overall survival of the group.7.Multivariate analysis of the above-mentioned single factor analysis P<0.05showed that the diameter of the metastases>5cm(P=0.032)and CRS>2(P=0.014)were the factors affecting the overall survival of the sequential chemotherapy gr oup.CRS>2 points was the factor that affected the overall survival of successful conversion therapy without surgery,P=0.019.Conclusion:1.Liver metastatic of colon cancer the sequential conversion treatment surger y progression-free survival and overall survival better than conversion treatment s uccess but not surgery.2.Sequential chemotherapy in patients with hepatic metastatic colon cancer h as a higher survival benefit than those who have achieved successful conversion but have not undergone surgery.3.CRS score may be an independent prognostic factor for progression-free su rvival and overall survival in patients undergoing sequential chemotherapy,and ma y also be an independent prognostic factor for patients who not in the surgery g roup after successful conversion therapy.Patients with high CRS scores have no p rogression and short overall survival.The prognosis is poor.4.Colon cancer liver metastasis lesions>5cm with poor prognosis,it may be an independent prognostic factor for the overall survival of patients surgical se quential chemotherapy.