Clinicopathological Features Of Patients With Initial Pulmonary Metastasis After Radical Resection Of Colon Cancer

Background and Objective: Colorectal cancer is one of the common malignant tumors of the digestive tract,with the third highest incidence and the second highest mortality rate.The main cause of death of patients is postoperative recurrence and metastasis.The lung is the second most metastatic site in colorectal cancer after the liver.In general,the incidence of lung metastasis in rectal cancer patients is higher than that in colon cancer patients.The reason may be that rectal cancer cells can directly metastasize to the lung after passing from the inferior rectal vein to the inferior vena cava,thus forming lung metastases.Colon cancer cells will first metastasize to the liver,which is carried out through the portal vein system.Clinically,some patients with colon cancer skip the liver and develop lung metastasis first.However,reports of such patients is less.Therefore,clinical data of patients with initial pulmonary metastasis after radical resection of colon cancer were collected in this study to analyze the relationship between clinicopathological features and disease-free survival(DFS),and to explore the possible influencing factors,so as to provide reference for the treatment plan and prognosis evalution.Methods: The case data of patients with colon cancer after radical resection in Anhui Provincial Hospital from October 2011 to April 2020 were collected by case retrieval method.Forty-seven patients with initial pulmonary metastasis after radical resection of colon cancer were screened through inclusion criteria and exclusion criteria.The clinicopathological features of 47 patients with initial pulmonary metastasis after radical resection of colon cancer were retrospectively analyzed.DFS was followed up.The follow-up time was up to July 2020.Statistical methods were used to compare the correlation between clinicopathological features and DFS.Results: A total of 47 patients with initial pulmonary metastasis after radical resection of colon cancer were included,including 14 patients with right lung metastasis,9patients with left lung metastasis,and 24 patients with bilateral lung metastasis.The median DFS of the whole group was 16.5 months.1.Univariate analysis showed that gender,age,location of primary lesion,T stage,N stage,degree of tumor differentiation,presence or absence of intestinal obstruction,preoperative CEA and CA199 levels were not correlated with the time of lung metastasis after colon cancer operation.2.The patients were divided into patients with single lung metastasis and double lung metastases according to the location of lung lesions.After comparison,it was found that age,gender,location of primary tumor,T stage,N stage,tumor differentiation degree,preoperative CEA and CA199 levels were not correlated with the location of lung lesions.3.Within 2 years after radical resection of colon cancer,the incidence of unilateral lung metastasis was 40.63%,and the incidence of bilateral lung metastasis was 59.38%,with no statistical significance(P=0.096).Conclusions: There was no significant correlation between the clinicopathological features of the patients and the time of lung metastasis after radical resection of colon cancer.The median DFS was 16.5 months.There were 23 patients with unilateral lung metastasis and 24 patients with bilateral lung metastases.The clinicopathological features and DFS of the patients were not related to the location of lung lesions.