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目的探讨结直肠癌肝转移根治术后远期疗效的影响因素。方法回顾性分析2010年8月至2012年8月我院收治的68例结直肠癌肝转移患者的临床资料,分析各临床特征与3年无瘤生存率及累积生存率的关系,并通过建立Cox比例风险模型多因素分析无瘤生存率及累积生存率的危险因素。结果无瘤生存率与累积生存率影响因素的单因素分析结果有良好一致性,分化程度、TNM分期、转移灶体积、转移灶数量、转移灶分布、肝切除范围及术前CEA水平同为两者影响因素(P<0.05),而性别、年龄、肿瘤部位、肝功能分级对结直肠癌肝转移患者远期疗效无显著影响(P>0.05)。多因素分析显示分化程度、TNM分期、转移灶数量、术前CEA水平为无瘤生存率及累积生存率的危险因素(OR>1且P<0.05)。结论结直肠癌肝转移患者根治术远期疗效的影响因素较多,无瘤生存率、累积生存率的影响因素不尽相同,而分化程度、TNM分期、转移灶数量、术前CEA水平是两者的共同影响因素,但上述结论仍需更大样本量研究证据支持。
Objective To investigate the long-term curative effect of radical resection of colorectal carcinoma after liver metastasis. Methods The clinical data of 68 patients with colorectal cancer with liver metastasis from August 2010 to August 2012 were retrospectively analyzed. The relationship between clinical features and 3-year disease-free survival rate and cumulative survival rate were analyzed. Cox proportional hazard model multivariate analysis of risk-free survival and cumulative survival risk factors. Results There was a good agreement between single-factor analysis of the factors influencing survival rate and cumulative survival rate. Differentiation degree, TNM stage, volume of metastasis, number of metastasis, distribution of metastasis, range of hepatectomy and preoperative CEA were the same as two (P <0.05), while gender, age, tumor location and grade of liver function had no significant effect on the long-term efficacy of colorectal cancer patients with liver metastasis (P> 0.05). Multivariate analysis showed that the degree of differentiation, TNM stage, number of metastases and preoperative CEA level were risk-free factors for disease-free survival and cumulative survival (OR> 1 and P <0.05). Conclusion There are many influencing factors for the long-term curative effect of radical surgery for patients with liver metastasis of colorectal cancer. The factors of tumor-free survival rate and cumulative survival rate are different, but the degree of differentiation, TNM stage, number of metastases and preoperative CEA level are two However, the above conclusions still need a larger sample of research evidence to support.