63例大肠癌肝转移患者的回顾性临床分析

目的 回顾性分析影响大肠癌肝转移患者预后的因素,并探讨手术切除加化疗、肝动脉栓塞灌注化疗、姑息化疗治疗大肠癌肝转移的疗效.方法 回顾性分析2001年至2007年间63例大肠癌肝转移患者的临床资料,采用多因素分析方法(Cox模型)分析大肠癌肝转移患者的临床特征、治疗方法及与预后的关系,并比较不同治疗方法的疗效.结果 63例大肠癌肝转移患者中位无疾病进展时间为6个月(0～50个月),中位生存期8个月(1～33个月).单因素生存分析显示术后至发生肝转移时间少于24 个月、术前CEA水平>15ng/ml、淋巴转移数、单纯肝动脉栓塞灌注化疗和姑息化疗的患者预后不良,P<0.05;多因素生存分析发现,治疗方法和术前CEA水平是影响预后的危险因素.结论 采用手术切除加化疗治疗大肠癌肝转移患者疗效较好.

Retrospective clinical analysis of 63 patients with liver metastasis of colorectal cancer

Objective This study aimed to investigate the efficacy of multiple therapeutic treatments on colorectal cancers with liver metastasis,and analyze prognostic factors.Methods From 2001 to 2007 in Heping Hospital of Changzhi Medical College,clinical data of 63 patients with confirmed liver metastasis of colorectal cancers were analyzed retrospectively.The prognostic factors correlated to clinical features and treatment approaches were determined using Cox multivariate model.Results The progression-free survival was 6 months(0-50 months) and the median survival was 8 months(1-33 months).Univariate survival analysis included the time of postoperative liver metastasis less than 24 months,the preoperative level of CEA greater than 15ng/mL,the number of lymph node metastases,hepatic artery embolism chemotherapy or palliative chemotherapy.Multivariate survival analysis showed risk factors of prognosis including treatment method and the preoperative level of CEA.Conclusions The combination of operation plus systemic chemotherapy might prolong the survival of patients with liver metastasis of colorectal cancers.The multiplicity results suggest that the treatment and the serum level of CEA before operation are primary risk factors of prognosis.