Analysis Of Prognostic Factors In Patients With Colorectal Liver Metastases Undergoing Simultaneous Resection

Objective:A retrospective study was conducted to analyze the clinical and pathological data of 69 patients with colorectal cancer liver metastasis who underwent simultaneous surgical treatment,and to analyze the factors affecting the prognosis of patients with colorectal cancer liver metastasis,so as to provide reference for future clinical diagnosis and treatment of related diseases.Methods:The basic data and clinical and pathological data of 69 patients with colorectal cancer liver metastases who underwent radical resection of colorectal cancer plus liver metastasis resection(including radiofrequency ablation)in the First Affiliated Hospital of Gannan Medical University from January 2018 to October 2022 were retrospectively analyzed.The data included age,gender,cell differentiation of primary tumor,preoperative neoadjuvant chemotherapy,regional lymph node metastasis(Vascular and nerve invasion data were obtained from the pathology department of our hospital),number of liver metastases,maximum diameter of liver metastases,T stage of primary tumor,preoperative CEA>200ng/ml level,preoperative CA19-9 level.The relevant enrolled patients were followed up through outpatient clinic,telephone and hospitalization log.IBM SPSS 26.0 statistical analysis application software was used to conduct statistical data processing on each sample data,and the median survival time and 1-year,3-year,and 5-year survival rates of 69 patients were obtained.Kaplan-meier method was used for univariate analysis,and the survival curve was drawn.Multivariate analysis was performed using Cox proportional hazards regression model to determine the independent factors affecting the survival rate of patients with colorectal liver metastases undergoing simultaneous liver resection.P<0.05 was considered statistically significant.Results:Sixty-nine patients with colorectal cancer who underwent simultaneous operation for liver metastasis were followed up.The 1-year survival rate was 96%,3-year survival rate was 64%,and 5-year survival rate was 25%.The median survival time was 42 months.Univariate Kaplan-Meier analysis showed that positive regional lymph nodes,cell differentiation degree of primary tumor,number of liver metastases,preoperative neoadjuvant chemotherapy,and T stage of primary tumor were the prognostic factors of patients with colorectal cancer liver metastases undergoing simultaneous surgical resection,and the differences were statistically significant(P<0.05).However,gender,age,maximum diameter of liver metastases,preoperative CEA level>200ng/ml,preoperative CA19-9 level,vascular and nerve invasion and other factors were not associated with poor prognosis of colorectal liver metastases,and the difference was not statistically significant(P>0.05).The results of multivariate analysis showed that the number of liver metastases,T stage of primary tumor and preoperative neoadjuvant chemotherapy were independent risk factors affecting the prognosis of patients with colorectal cancer liver metastases undergoing simultaneous surgery(P<0.05).However,regional lymph node metastasis and cell differentiation of the primary tumor were not independent risk factors for the prognosis of patients with colorectal liver metastases undergoing simultaneous operation(P>0.05).Conclusion:1.Univariate analysis showed that the relationship between the factors influencing the prognosis of patients with concurrent surgical resection of liver metastases of colorectal cancer was as follows: the degree of primary tumor differentiation was lower,lymph node metastasis existed,no neoadjuvant chemotherapy was received before surgery,the number of liver metastases was greater than 3,and the prognosis of patients with concurrent surgical resection of liver metastases of colorectal cancer with primary tumor stage T4 was worse.2.Multivariate analysis showed that the relationship between prognostic factors affecting concurrent surgical resection of liver metastases of colorectal cancer was as follows: patients with concurrent surgical resection of liver metastases of colorectal cancer who did not receive neoadjuvant chemotherapy before surgery,the number of liver metastases was greater than 3,and the primary tumor at stage T4 had worse prognosis,and were independent influencing factors affecting the prognosis of concurrent surgical resection of liver metastases of colorectal cancer.