Lung metastasis and synchronous liver metastases of colorectal cancer:A survival analysis

DENG Zi-jian1; ZHANG Ke2; YI Bo2; LIU Peng1; YAN Jin1

doi:10.3969/j.issn.1674-4136.2020.02.009

Abstract：Objective To investigate survival in patients with simple lung metastases or synchronous and simple liver metastases of colorectal cancer and identify risk factors associated with survival. Methods Clinical, pathologic，treatment and complete follow-up data of 46 patients with simple lung metastasis of colorectal cancer (including 22 patients with simultaneous lung metastasis and 24 patients with heterochrony lung metastasis) and 91 patients with simultaneous liver metastasis of colorectal Cancer in Sichuan Cancer Hospital were analyzed retrospectively. A survival analysis was performed to investigate related factors affecting the survival. The prognostic; value of different factors were determined by the medthod of univariate and multivariate analyses. Results The median survival was 58. 0 months and 5-year survival rate was 47.8% of 46 cases of simple lung metastasis. The median survival time and 5-year survival rate in the operation group were significantly better than those in the chemotherapy group (P<0.01). The results of univariate analysis showed that the survival time of female patients with simultaneous lung metastasis，non-surgical treatment of metastases，the number of metastases≥3，and the survival time of patients with metastasis involves both lungs and primary focus unresected were significantly shortened (P<0.01). The results of multivariate analysis showed that the results of univariate analysis were not independent risk factors. The median survival was 22. 0 months，3-year survival rate was 33.3% and 5-year survival rate was 0% of 91 cases of synchronous liver metastases. Munivariate analysis showed that the median survival time and 3-year survival rate in the operation group were significantly higher than those in the other groups (P<0.01). One factors were found to be significant and independent predictors of poor survival by multivariate analysis: no surgical treatment of liver metastases ( P= 0. 014)，and no local regional treatment of liver metastases (P=0.001). Conclusions Survival of synchronous lung metastases is lower than that of heterochrony lung metastases. Resection of liver or lung metastases provides good long-term survival benifit for patients with resectable metastases. Active surgical treatment for strictly selected patients with simple and synchronous liver metastasis and lung metastasis may improve the survival rate of patients.