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目前,尤其是在国内,仍缺乏大规模的、高质量的转移性结直肠癌(metastatic colorectal cancer,mCRC)真实世界数据.目前尚不清楚在真实世界临床实践中提高mCRC患者的治疗质量能否为我国mCRC患者带来生存获益.基于智能大数据平台,我们建立了一个大样本的mCRC回顾性队列.我们分析了全身性治疗及局部治疗手段[包括肝转移、肺转移或肝外和(或)肺外转移灶的手术切除、射频消融以及立体定向放疗]随年份的变化趋势,以及分析了这些改变是否可改善患者的总生存期(overall survival,OS).在2012年7月至2018年12月期间,共纳入3403名符合条件的mCRC患者.本研究队列的中位OS为42.8个月[95％置信区间(confidence interval,CI),40.7～46.6];其中,仅接受了全身性治疗的患者的中位OS为25.6个月(95％CI,24.7～26.9),而接受了局部治疗的患者的中位OS未达到(95％CI,78.6个月至未达到).接受局部治疗的患者比例持续升高,从2012—2014年的37.9％逐步上升到2017—2018年的46.9％.西妥昔单抗/贝伐珠单抗的使用率从2017年开始明显增加(在2012—2014年、2015—2016年、2017—2018年分别为39.9％、43.2％及60.3％).相比2012—2014年的患者,2015—2016年的患者的OS显著延长[风险比(hazard ratio,HR)=0.87(95％CI,0.78～0.99);P=0.034],而仅接受全身性治疗的患者则无显著差异[HR=0.99(95％CI,0.86～1.14);P=0.889];相比2012—2014年的患者,2015—2016年的患者的OS显著延长[HR=0.75(95％CI,0.70～0.81);P<0.001],并且该优势在仅接受全身性治疗的患者中依然存在[HR=0.83(95％CI,0.77～0.91);P<0.001].综上,本队列研究表明mCRC全身性治疗及局部治疗的使用率的提高可以为患者带来生存获益.“,”There is a lack of high-quality, large-scale, real-world evidence from patients with metastatic colorectal cancer (mCRC), especially in China. It remains unclear whether efforts to improve the quality of care for mCRC would improve patient survival outcomes in real-world practice. On the basis of an intelligent big-data platform, we established a large-scale retrospective cohort of mCRC patients. We investigated the temporal changes in the systemic and local treatment (resection, ablation, or radiation to liver, lung, or extrahepatic and/or extrapulmonary metastases) patterns of mCRC, and whether these changes were associated with improved overall survival (OS) over time. Between July 2012 and December 2018, 3403 eligible patients were included in this research. The median OS was 42.8 months (95％confidence interval (CI), 40.7–46.6) for the entire cohort, 25.6 months (95％CI, 24.7–26.9) for those treated with sys-temic therapy only, and not reached (95％CI, 78.6 months–not reached) for those receiving local therapy. The utility rate of local therapy increased continuously from 37.9％in 2012–2014 to 46.9％in 2017–2018. A dramatic increase in the utility rate of either cetuximab or bevacizumab was observed since 2017 (39.9％, 43.2％, and 60.3％ in 2012–2014, 2015–2016, and 2017–2018, respectively). Compared with 2012–2014, the OS of the entire population significantly improved in 2015–2016 (hazard ratio (HR) = 0.87 (95％ CI, 0.78–0.99); P = 0.034), but not for patients receiving systemic therapy only (HR = 0.99 (95％ CI, 0.86–1.14); P = 0.889), whereas an improved OS was found in 2015–2018 for both the entire population (HR = 0.75 (95％ CI, 0.70–0.81); P < 0.001) and for patients receiving systemic therapy only (HR = 0.83 (95％ CI, 0.77–0.91); P < 0.001). In summary, the quality of care for mCRC, as indicated by the utility rate of targeted and local therapies, has been continuously improving over time in this study cohort, which is associated with continuously improving survival outcomes for these patients.