左右半结肠癌肝转移患者术后生存差异的研究

发布时间：2018-06-27 22:11

  本文选题：结肠癌 + 位置　； 参考：《北京协和医学院》2017年硕士论文

【摘要】：研究背景:结直肠癌是临床常见恶性肿瘤,肝脏是结直肠癌最好发的转移部位,在结直肠癌患者中,2/3死因与肝转移相关,因此,对于结直肠癌肝转移的诊治尤为重要。目前有关于结肠癌原发灶位置与CRCLM术后长期生存相关性的研究。本文旨在研究原发于左半及右半结肠的CRCLM患者在DFS以及OS上的差异,并分析预后相关因素。研究方法:回顾性分析北京协和医学院中国医学科学院肿瘤医院2009-2016年行根治性治疗(包括联合射频消融治疗)的结肠癌肝转移患者的诊断、治疗及预后等临床资料。将原发灶位于乙状结肠、降结肠、脾曲的患者归为左半结肠组,位于盲肠、升结肠、横结肠的患者归为右半结肠组,利用统计学软件SPSS v20进行统计学分析,比较两组的生存差异,并分析其预后因素。研究结果:共有97例患者纳入本研究,原发于左半结肠65例、右半结肠32例,两组患者除接受新辅助化疗比例外,余临床病理特征无明显差异。全部患者中位无疾病生存时间(DFS)9.0月,中位总生存时间(OS)41.0月,左、右半结肠组中位DFS分别为6.0月和9.0月,两者无统计学显著性差异(P=0.579)。左、右半结肠组中位OS(54.0月VS 33.0月)及5年生存率(34.8%VS 17.4%),亦无统计学显著性差异(P=0.270)。单因素分析术前CA19-9、术前CEA、是否接受新辅助化疗、肝转移灶数量≥4与患者DFS有关,仅肝转移灶≥4是OS的危险因素。结论:本研究结果表明肝转移灶数量是结肠癌肝转移术后影响总生存的独立预后因素。与右半结肠癌肝转移相比,左半结肠癌肝转移患者行根治性治疗术后DFS更短,OS延长,但均未达到统计学显著性差异。
[Abstract]:Background: colorectal cancer is a common clinical malignant tumor, the liver is the best metastatic site of colorectal cancer. Two thirds of the causes of death are related to liver metastasis in patients with colorectal cancer. Therefore, the diagnosis and treatment of liver metastasis of colorectal cancer is particularly important. There is a study on the correlation between the location of primary colon cancer and long-term survival after CRCLM. The purpose of this study was to study the difference of DFS and OS in CRCLM patients with primary left and right hemicolon and to analyze the prognostic factors. Methods: the diagnosis, treatment and prognosis of patients with liver metastases from colon cancer treated with radical therapy (including radiofrequency ablation) from 2009 to 2016 in Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, were retrospectively analyzed. The patients with primary lesions located in sigmoid colon, descending colon and splenic flexure were classified as left hemicolon group, cecum, ascending colon and transverse colon group as right hemicolon group. Statistical software SPSS v20 was used for statistical analysis. The survival difference between the two groups was compared and the prognostic factors were analyzed. Results: a total of 97 patients were included in this study. There were 65 cases of left hemicolon and 32 cases of right hemicolon. Except for the proportion of neoadjuvant chemotherapy, there was no significant difference in clinicopathological features between the two groups. The median disease-free survival time (DFS) was 9.0 months, the median total survival time (OS) was 41.0 months, and the median DFS was 6.0 months and 9.0 months in the left and right hemicolon groups, respectively. There was no significant difference between the two groups (P0. 579). The median OS (54.0 months vs 33.0 months) and the 5-year survival rate (34.8vs 17.4%) in the left and right hemicolon groups were not significantly different (P = 0.270). Univariate analysis showed that preoperative CA19-9, preoperative CEA, neoadjuvant chemotherapy or not, the number of liver metastases 鈮，

本文编号：2075445