Analysis Of High Risk Factors Of Liver Metastasis In Patients With Postoperative Colorectal Cancer

Objective: The aim of this study is to filter the risk factors of liver metastasis inpatients with postoperative colorectal cancer, which can set up a mathematic model.Application of this model can predict the possibility of postoperative liver metastasis,then take early diagnosis, early treatment and improve the survival.Methods: The clinical data of168patients with colorectal cancer who underwentradical surgery in first affiliated Hospital of Dalian Medical University from January2006to January2012were retrospectively analyzed and follow-up. There are89malecases,79female cases,95patients of colon cancer and73patients of rectal cancer inthis group. Using chi-square test for univariate analysis to clear clinical factorsassociated with survival rate and liver metastases occurred. Putting the significantdifferences into the logistics model regression method and identify the risk factors forliver metastasis. The ROC test is applied to complete a mathematic model for livermetastasis in patients with postoperative colorectal cancer.Results:3and5-year survival rate was72.0%and46.4%respectively in wholegroup. Univariate analysis showed that the clinical factors of3/5year survival rate werelymph node metastasis, TNM stage,tumor invasive depth, histological type of tumor andhistological grading.56patients had liver metastases in whole group, and3and5-yearincidence rate of liver metastasis was25.0%and33.3%respectively. There are32malecases,24female cases,29patients of colon cancer and27patients of rectal cancer inthis group. Logistics model regression method analysis showed the risk factors of livermetastasis were lymph node metastasis,tumor invasive depth, histological type andhistological grading; not related to sex, age, the site of the cancer and general type.Conclusions: Lymph node metastasis, TNM stage, tumor invasive depth,histological type of the tumors and histological grading were significantly related to3or 5year survival rate, not related to sex, age, duration of disease, past history ofdisease,the site of the cancer and adjuvant treatment. The risk factors of liver metastasiswere lymph node metastasis, tumor invasive depth, histological type and histologicalgrading through statistical analysis. The mathematic model of liver metastasis inpatients with postoperative colorectal cancer was: logit(P)=-9.031+0.973×LNM+0.302×TID+0.637×Histology+0.042×PSM(LNM: Lymph node metastasis; TID:Tumor invasive depth; PSM: Preoperativeserum tumor markers). From the ROC test, we got that when P=0.45, it has the highestsensitivity and specificity (Sensitivity=75%,Specificity=84%), which equals that whenP≥0.45it is high-risk of liver metastasis, and when P<0.45, it is low-risk of livermetastases.