| Objective:Metastatic colorectal cancer seriously threatens people's lives.As colonoscopy continues popularity,most of the populations can find tumors as early as possible and undergo excision or neoadjuvant treatment.Long-term prognosis of patients with I-III colorectal cancer after operation is better.However,the prognosis of patients with metastatic colorectal cancer is extremely poor.Countless advanced patients suffering from great psychological and physical torment.To investigate survival in patients with simple lung metastases or synchronous and simple liver metastases of colorectal Cancer and identify risk factors associated with survival.This study excluding patients with imultaneous liver and lung metastases.Resection of primary lesions in mCRC patients,and the timing of resection remains controversial.This retrospective analysis is expected to serve clinical decision-making and enable more patients to benefit from the initial treatment strategy.Methods:Clinical basic test and examination data,pathological differentiation characteristics,different treatment methods and prognosis and survival status of 46 patients with simple lung metastasis of colorectal cancer(including 22 patients with simultaneous lung metastasis and 24 patients with heterochrony lung metastasis)and 91 patients with simultaneous livermetastasis of colorectal Cancer in Sichuan Cancer Hospital were analyzed retrospectively.To investigate the effect of clinical test data,pathological data and different treatment methods on the prognosis of patients.Multifactorial analysis using the cox regression model.Results:The median survival was 58.0 months and 5-year survival rate was 47.8% of 46 cases of simple lung metastasis.The median survival time and5-year survival rate in the operation group were significantly better than those in the chemotherapy group(P < 0.01).The median survival time of the primary focus resection group(n =15)was 39(12-61)months,and the 5-year survival rate was 18.2%,higher than that of the primary focus resection group(n =7)at22(6-32)months and 0%,The difference was statistically significant(2=8.701,P =0.003).The median survival time and 3-year survival in the surgical group were significantly better than in the other groups(?2=30.500,P <0.001).The median survival time was 14(0.3-32)months in the primary focus unresection group(n =33)and 0% in the 3-year survival rate;lower than 16(5-38)months and 51.1% in the primary focus excision group(n =58),The difference was statistically significant(?2=7.760,P =0.005).The results of univariate analysis showed that:The survival time of female patients with lung metastases,non-surgical treatment of metastates,number of metastates ?3,metastates involving both lungs,simultaneous lung metastases,primary focus not resected,and poorly differentiated adenocarcinoma were significantly shortened survival time(P < 0.05);The survival time of no chemotherapy with liver metastases,primary focus not resected/radiotherapy,maximum liver metastases ?5 cm?liver metastases ?5,liver metastases non-surgical/local treatment,CEA?5ng/ml,and poorly differentiated adenocarcinoma were significantly shortened(P <0.05).Two factors were found to be significant and independent predictors of poor overall survival by multivariate analysis: no surgical treatment of liver metastases,no local regional treatment of liver metastases(P=0.002);and CA199?35(ng/ml)(P=0.003).Conclusion:Survival of synchronous lung metastases is lower than that of heterochrony lung metastases.Resection of liver or lung metastases provides good long-term survival benifit for patients with resectable metastases.Active surgical removal of primary or metastatic lesions in critically selected mCRC after multidisciplinary team discussion may be beneficial to survival. |
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