Analysis Of The Effect Of The First Surgery And Primary Chemotherapy On Colorectal Cancer Synchronous Liver Metastasis

Objective:Colorectal cancer is one of the most common maligant tumors in China,occupying the third place of the incidence of maligant tumors and the incidence is on the rise.The liver is the most common metastatic site and is the leading cause of death.With the in-depth study of colorectal cancer of liver metastases(CRLM),many international consensus and guidelines have been developed.However,there is still a lot of controversial issues to this day.First surgery and primary chemotherapy is one of the most controversial issues.This article studied and analyzed the surgical safety,local recurrence rate and survival rate of patients with resectable colorectal cancer synchronous liver metastasis in the two treatment modalities,so as to provide ideas and theoretical reference for the majority of my colleagues in the treatment of CRLM.Methods:Retrospective analysis of 51 patients with resectable colorectal cancer synchronous liver metastasis from September 2010 to September 2012 in the China-Japan Union Hospital of Jilin University.Among them,28 patients underwent simultaneously surgical resection and then postoperative chemotherapy(first Surgery group).23 patients received neoadjuvant chemotherapy followed by surgical resection combined with postoperative chemotherapy(first chemotherapy group).Analysis of the two groups of patients in the safety of surgery,the local recurrence rate and the difference between the survival rate.Results:The average total blood loss of the first surgery group was 312.14 ± 12.06 ml,and the average total blood loss of the first chemotherapy group was 313.91 ± 13.10 ml.The mean operation time of the first surgery group was 245.00 ± 7.32 min,and the average operation time of the first chemotherapy group was 246.96 ± 8.56 min.The incidence of surgical complications in the first surgery group was 21.43%.The incidence of surgical complications in the first chemotherapy group was 21.73%.There was no significant difference between the two groups(P> 0.05).The local recurrence rates in the first operation group were 25.00%,46.43% and 85.71% at one year,three years and five years respectively.The local recurrence rates of the first chemotherapy group at one year,three years and five years respectively,21.74%,43.48% and 82.61%.There was no significant difference between the two groups(P> 0.05).The recurrence rate was comparable.The 1-year,3-year and 5-year survival rates of the first surgery group were 96.43%,46.43% and 39.29%.The 1-,3-and 5-year survival rates of the first chemotherapy group were 95.65%,52.17% and 39.13% There was no significant difference between the two groups(P> 0.05),and the survival rate was comparable.Conclusion:Surgical safety,local recurrence,and survival are comparable in patients who have undergone first surgery and primary chemotherapy for concurrent resectable colorectal cancer synchronous liver metastasis.The timing of the surgery should be evaluated by the multidisciplinary team(MDT)conduct a comprehensive assessment,individualized treatment goals,select the best combination of treatment.