The Clinical Characteristics And Prognosis Of Patients With Unresectable Synchronous Colorectal Cancer Liver Metastases

Object:Our study evaluated the progression free survival(PFS)and overall survival(OS)of patients of unresectable synchronous colorectal cancer liver metastases(USCRCLM)and recognized the prognosis factors in order to improve their survivalMethods:Patients of USCRCLM were identified from January 2010 to December 2015.We retrospectively analyzed their prognosis by using Kaplan-Meier method to conduct the survival analysis and found out the prognostic factors by performing log-rank test in way of pooled over strata.Univariate and multivariate analysis was conducted by using cox regression model.All the analysis was conducted by using IBM SPSS Statistics 20.Significant P value was set at 0.05.Results:As for the first study,we finally recruited 157 patients with USCRCLM,102 were male.The median age was 61 years old.The median PFS and OS was 7 months(Interquartile Range,IQR:4-10)and 11 months(IQR:7-16)respectively.We finally identified 7 factors correlated with prognosis which were age,number of LMs,maximum diameter,serum CEA level at diagnosing time,chemotherapy response,LM resection and primary tumor resection.Both PFS and OS of patients with the evaluation of CR/PR,SD and PD were significantly different(P<001).Especially,patients who had the LM resected showed 5-month longer PFS and 9-month longer OS than those who did not(P<001),no matter synchronously or metachronously(PFS:P=0.382,OS:P=0.879).For the second study,we recruited 105 patients with USCRCLM who failed conversion chemotherapy.The median age was 60 years old and the median OS was 11 months(IQR:8-18).Finally we identified the stage of LN,maximum diameter of LMs,chemotherapy response and whether performing second chemotherapy as the prognosis factors of patients who failed the conversion chemotherapy.Conclusion:As for patients who both are responsive to chemotherapy and achieve a relative successful conversion may be more feasible to undergo LM resection surgery,regardless of synchronously or metachronously.As for patients who failed the conversion chemotherapy,stage of LN,maximum diameter of LMs,chemotherapy response and whether performing second chemotherapy all can affect their prognosis We should perform different but proper medical support according to their specific disease status.