Survival And Prognosis Of Primary R0 Resected Patients With Lung Metastasis From Colorectal Cancer

Objective:To explore the related factors affecting survival and prognosis of patients with lung metastasis from colorectal cancer.Methods:The clinicopathological features and survival follow-up data of 100 patients with lung metastasis from colorectal cancer who underwent R0 resection were retrospectively analyzed From January 2013 to November 2017 in the Department of Gastrointestinal Oncology,affiliated in Cancer Hospital of Fujian Medical University.Kaplan-Meire method was used to draw the survival curve.Univariate analysis(Log-rank test)and multivariate COX regression analysis were used to determine risk factors affecting survival and prognosis.Chi-square test was used to compare the differences among different groups.Results:The median follow-up time was 51.6months(11.3-120)and median survival time was 25.4 months(2.1-85.1).Univariate analysis showed that synchronic and metachronous metastasis,mutation of KRAS gene,extrapulmonary metastasis,and molecular targeted therapy after operation were all factors influencing the overall survival of patients with lung metastasis from colorectal cancer(P < 0.05).Multivariate analysis showed that synchronic and metachronous metastasis(P = 0.006),KRAS gene mutation status(P = 0.043),extrapulmonary metastasis(P = 0.050),molecular targeted therapy after operation(P = 0.021),Primary foci(colon / rectum,P = 0.021)were independent risk factors of survival and prognosis.In addition,the subgroup analysis: in patients with simple lung metastasis,the patients treated with lung metastasis(compared with those without treatment of lung metastasis)had a longer survival time.Conclusion:Synchronic lung metastasis,KRAS gene mutation and extrapulmonary metastasis are negative prognostic factors of patients with lung metastasis from CRC.Compared with the patients who had not receive molecular targeted therapy after operation,the patients who received targeted therapy more than 4 cycles had a longer survival time.The prognosis of patients who treated with lung metastasis was better than those without treatment amomg simple lung metastasis patients.