Prognostic Factors Of Colorectal Cancer Liver Metastases And Evaluation Of TACE Therapy

BackgroundColorectal cancer（CRC）is one of the three major malignant tumors in the world,and its incidence is second only to lung cancer and female breast cancer.It has become the second leading cause of cancer-related death in2020^[1].Metastasis is the leading cause of cancer-related death in CRC patients.Due to the dual venous system and complex lymphatic system of the liver,the liver is the organ most likely to involve metastasis in CRC.Nearly 50%of all patients diagnosed with CRC will be diagnosed with colorectal cancer liver metastases（CRLM）in the overall course of the disease.However,the efficacy and safety of TACE treatment for CRLM liver metastases are still controversial.This study retrospectively analyzed the related factors of CRLM affecting the prognosis of the disease,and evaluated the prognosis of CRLM patients.The survival status of the TACE group and the control group without liver metastases intervention was analyzed and compared,and the efficacy and safety of TACE in the treatment of CRLM were determined.Disease treatment options provide relevant evidence.MethodIn this study,retrospective analysis was used to collect the medical history data of 64 patients with colorectal cancer liver metastases who were treated in our hospital from January 2014 to December 2018,and followed up.After screening,they were divided into Liver metastasis intervention group（29cases treated by operation and 18 cases treated by TACE）and control group,17 cases.The prognostic factors of CRLM were analyzed.The survival curve was drawn by Kaplan-Meier method..The survival status of the TACE group and the control group without liver metastases were analyzed and compared.Follow-up termination conditions:death or follow-up of 36 months,until January 2022.Result1.A total of 64 patients with colorectal cancer liver metastases were included,the median survival time was 28months2.The univariate analysis of CRLM prognosis showed that the infiltration depth of the primary tumor,Local lymph node metastasis,the largest diameter of liver metastases,the number of liver metastases,the level of CA19-9,and the presence or absence of interventional treatment for liver metastases were associated with overall survival;multivariate results showed that The infiltration depth of primary tumor,CA19-9 level and the presence or absence of interventional treatment in metastatic lesions are independent factors affecting prognosis.3.KM survival analysis showed that the 1-,2-,and 3-year OS of TACE treatment were higher than those of the control group without liver metastases intervention,and the difference was statistically significant.Conclusion1.Patients with CRLM patients with liver metastases less than 5 cm in the largest diameter have a better prognosis than patients with liver metastases≥5 cm.2.The 3-year survival rate of patients with normal CA19-9 level at the time of diagnosis of CRLM is higher than that of patients with higher CA19-9 level.CA19-9 can be used as an effective supplement to monitor the prognosis of CRLM.3.TACE treatment can improve the 3-year survival rate of CRLM patients and is an effective treatment for prolonging the survival period.However,this treatment will produce many adverse reactions,which need to be carefully selected under comprehensive evaluation.