Multivariate Prognostic Analysis Of Patients With Colorectal Cancer Liver Metastasi

Purpose:Through the retrospective analysis of the case data of patients with liver metastasis of colorectal cancer and the follow-up of their survival time,we try to find the potential factors affecting the prognosis of patients with crlm,analyze the use of traditional Chinese medicine,and count the frequency,drug properties,drug taste and meridian of high-frequency drugs,in order to guide clinical treatment and improve the overall survival.Materials and methods:Patients with colorectal cancer liver metastases who were hospitalized in the Department of Oncology,Liaoning Provincial Hospital of Traditional Chinese Medicine from January 2015 to December 2021 were selected,and the follow-up endpoint was reached before December 31,2021,and the patient’s case data and follow-up endpoints were retrospectively recorded.The time,that is,the overall survival(OS),the time unit is months.The general information of the cases and patients were recorded separately: age,gender,past history(smoking/drinking);pathological characteristics: primary site,degree of differentiation,pathological type;time limit of liver metastasis,treatment method and liver function grading of liver metastasis;treatment of lesions : Primary tumor surgery,systemic chemotherapy,chemotherapy single/multi-drug;laboratory indicators: carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),serum albumin,NLR ratio,PLR ratio,hemoglobin;use of traditional Chinese medicine Conditions,frequency of high-frequency drugs,drug properties,drug flavors,meridian-returning statistics and TCM syndrome types. Excel was used for data summary,and SPSS 26.0 software was used for data analysis.The chi-square test was used for the composition of each group,and the overall survival(OS)was compared by the Kaplan-Meier method,and the survival curve was drawn.Log-Rank was used for univariate analysis,and the single factor with statistical significance was included in the COX regression model for multivariate analysis.P value < 0.05 was regarded as statistically significant.The composition of traditional Chinese medicine decoctions used in all the included cases was collected,and the frequency of occurrence of high-frequency drugs and their properties and flavors were collected.Results:1.Univariate analysis indicated: gender(P=0.043),primary tumor site(P=0.045),tumor differentiation degree(P<0.001),liver metastasis duration(P<0.001),liver metastases burden(P<0.001)),liver function grade(P=0.030),primary tumor surgery(P<0.001),systemic chemotherapy(P<0.001),neutrophil-to-lymphocyte ratio(P=0.030),hemoglobin(P=0.002)),the use of traditional Chinese medicine(P < 0.001),and the distribution of TCM syndrome types(P = 0.015),the differences between the above factors were statistically significant.The median survival time of female patients was 25.00 months,which was better than that of male patients,22.00 months;the median survival time of the left colon group was24.00 months,which was better than that of the right colon group,14.00 months;the median survival time of the poorly differentiated group was 15.00 months,which was significantly inferior The median survival time in the moderately differentiated group was 28.00 months,and in the well-differentiated group was 34.00 months;the median survival time of the metachronous liver metastasis group was 37.00 months,which was significantly better than that of the synchronous liver metastasis group,17.00 months;the median survival time of the unilobular metastasis group was 34.00 months.The median survival time of the liver function class A group was 34.00 months,which was better than that of the liver function class B group,22.00 months,and that of the liver function class C group,15.00 months;the median survival time of the primary tumor surgery group The survival time of 33.00 months was significantly better than that of the no-surgery group,which was 14.00 months;the median survival time of the systemic chemotherapy group was 35.00 months,which was better than that of the non-chemotherapy group,which was 13.00 months;the median survival time of the low NLR group was 36.00 months,which was better than that of the high NLR group,which was 17.00 months.months,x2=4.690;the median survival time of the normal hemoglobin group was 34.00 months,which was better than that of the abnormal group,17.00months;the median survival time of the group using traditional Chinese medicine for more than 6 months was 28.00 months,which was significantly better than that of the group using traditional Chinese medicine less than 6 months,which was 11.00 months.months.Among the TCM syndrome types,the median survival time of the liver-kidney yin deficiency group was 14.00 months,the spleen-kidney yang deficiency group was 14.00 months,and the median survival time was 37.00 months in the damp-heat accumulation group,34.00 months in the liver stagnation and qi stagnation group,and 34.00 months in the spleen-kidney yang deficiency group.24.00 months in the spleen deficiency and dampness sleep syndrome group.2.COX multivariate analysis showed that the time limit of liver metastasis(P=0.005),systemic chemotherapy(P=0.003),primary tumor surgery(P=0.005),and the use of traditional Chinese medicine(P=0.036)were the main factors affecting liver metastasis of colorectal cancer.Independent factors for patient prognosis.Drug analysis of traditional Chinese medicine decoction: There are 21 drugs with a frequency of ≥30 times.Hedyotis diffusa,Scutellaria barbata,Tuckahoe,dried tangerine peel,white peony root,Scutellaria baicalensis,raw oyster,melon,Prunella,raw keel,Amomum,Yin Chen.The frequency analysis of the properties,taste and meridian of high-frequency medicines: 21 high-frequency medicines are mostly rectifying and tonifying,detoxifying and dispelling;the five flavors are mainly bitter,sweet and acrid;the four qi are mostly cold-flavored drugs,followed by warm and flat;the main channel of return is the lung,stomach and liver.Conclusion:In this study,by analyzing the selected variables,male patients with lesions located in the right colon,lower differentiation degree,higher NLR ratio,higher liver metastatic tumor burden,and poor liver function grade had shorter overall survival and poorer prognosis.Most of the patients have liver-kidney yin deficiency syndrome and spleen-kidney yang deficiency syndrome.Further analysis showed that simultaneous liver metastases,no systemic chemotherapy,no primary tumor resection,and no standardized long-term oral administration of traditional Chinese medicine decoction were independent factors affecting the prognosis of patients with CRLM.In patients with advanced CRLM,oral decoctions are mainly used to strengthen the body and tonic,detoxify and disperse stagnation.