144例结直肠癌肝转移原发灶切除术后临床病理特征和预后分析

摘要

目的：分析144例结直肠癌肝转移原发灶切除术后患者的临床病理特征和预后。方法：回顾性分析病理证实的144例结直肠癌肝转移原发灶切除术后患者的临床病理特征和预后，Kaplan －Meier 法分析生存率，Log －rank 检验比较组间生存差异。结果：144例结直肠癌肝转移组及其中77例结直肠癌同时性肝转移亚组的中位生存期分别为28个月和21个月，所有病例分析显示原发肿瘤分化程度、肝转移发生时间、肝转移灶数目及治疗方法与预后显著相关（P ＜0．05）；同时性肝转移亚组分析显示原发肿瘤分化程度、性别、TNM分期与预后显著相关（P ＜0．05）；两组病例分析显示年龄对患者总生存期的影响无统计学差异（P ＞0．05）。结论：原发肿瘤低分化、同时性肝转移、多发肝转移及单纯化疗是结直肠癌肝转移原发灶术后患者独立预后不良因素。原发肿瘤低分化、男性及Ⅱ－Ⅲ期是结直肠癌同时性肝转移原发灶术后患者独立预后不良因素。年龄对结直肠癌肝转移原发灶切除术后患者总生存期的影响无统计学意义。%Objective:To analyze the clincopathological features and prognosis of 144 colorectal cancer liver me-tastases after resection of the primary tumors.Methods:One hundred and forty -four patients with colorectal cancer liver metastases who underwent resection of the primary tumors and pathologically confirmed were enrolled in this ret-rospective study.The clincopathological features and prognosis were analyzed.Kaplan -Meier method was used to an-alyze survival rates.The differences between survival curves were calculated by log -rank test.Results:The median survival period of all cases and subgroup were 28 months and 21 months,respectively.In all cases analysis that tumor differentiation,time of liver metastases,number of liver metastases and treatment methods were associated with progno-sis(P <0.05).The subgroup analysis showed that tumor differentiation,Gender and TNM stage were associated with prognosis (P <0.05).All cases and subgroup analysis demonstrated no differences in age(P >0.05).Conclusion:Low differentiation,synchronous liver metastases,multiple liver metastases and pure chemotherapy were independent poor prognosis factors.Subgroup analysis showed that the low differentiation,male,stage Ⅱ -Ⅲ were independent poor prognosis factors.Age was not associated with prognosis.