Ma ZH, Wang YP, Zheng WH, Ma J, Bai X, Zhang Y, Wang YH, Chi D, Fu XB, Hua XD. Prognostic factors and therapeutic effects of different treatment modalities for colorectal cancer liver metastases. World J Gastrointest Oncol 2020; 12(10): 1177-1194 [PMID: 33133385 DOI: 10.4251/wjgo.v12.i10.1177]
Corresponding Author of This Article
Xiang-Dong Hua, MD, Chief Doctor, Surgeon, Department of Hepatopancreatobiliary Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Shenyang 110042, Liaoning Province, China. lnzl_hxd@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Oct 15, 2020; 12(10): 1177-1194 Published online Oct 15, 2020. doi: 10.4251/wjgo.v12.i10.1177
Prognostic factors and therapeutic effects of different treatment modalities for colorectal cancer liver metastases
Zuo-Hong Ma, Yong-Peng Wang, Wen-Heng Zheng, Ji Ma, Xue Bai, Yong Zhang, Yuan-He Wang, Da Chi, Xi-Bo Fu, Xiang-Dong Hua
Zuo-Hong Ma, Yong-Peng Wang, Xue Bai, Yuan-He Wang, Da Chi, Xi-Bo Fu, Xiang-Dong Hua, Department of Hepatopancreatobiliary Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Wen-Heng Zheng, Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Ji Ma, Yong Zhang, Department of Pathology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Author contributions: Ma ZH and Hua XD conceived this study and takes responsibility for the integrity of the data and the accuracy of the data analysis, including and especially any adverse effects; Wang YP, Zheng WH, Zhang Y, and Bai X improved the study design and contributed to the interpretation of results; Chi D and Fu XB performed data processing and statistical analysis; Ma ZH wrote the manuscript; Ma J and Wang YH revised the manuscript; and all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute (Approval No. 20200102).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiang-Dong Hua, MD, Chief Doctor, Surgeon, Department of Hepatopancreatobiliary Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Shenyang 110042, Liaoning Province, China. lnzl_hxd@163.com
Received: July 20, 2020 Peer-review started: July 20, 2020 First decision: August 9, 2020 Revised: August 18, 2020 Accepted: September 14, 2020 Article in press: September 14, 2020 Published online: October 15, 2020 Processing time: 86 Days and 2.6 Hours
ARTICLE HIGHLIGHTS
Research background
Methods such as hepatectomy, ablation therapy, interventional therapy, and systemic chemotherapy improve the quality of life and prolong survival. Through the comparison of different prognostic factors and treatment plans, it is hoped that a more reasonable treatment plan will be obtained, which will provide evidence-based basis for clinical treatment.
Research motivation
This study analyzed the prognosis of different treatment methods, combining pathological characteristics and prognostic factors to formulate the most suitable treatment plan for patients.
Research objective
Through the comparison of prognostic factors and treatment rules, it is hoped that a more reasonable treatment plan will be obtained, which will provide evidence-based basis for clinical treatment.
Research methods
The clinicopathological data and postoperative survival of four groups of colorectal cancer patients with liver metastases (surgical resection group, ablation treatment group, interventional treatment group, and chemotherapy alone group) were retrospectively analyzed. The survival analysis was performed by the Kaplan-Meier method, and multivariate Cox proportional hazard regression model was used for analysis.
Research results
The Cox proportional hazards model showed that the following factors are independent factors affecting prognosis: The degree of tumor differentiation, the number of metastases, the size of metastases, and whether the metastases are close to great vessels. The effect of surgical treatment was better than that of drugs, intervention, or ablation alone.
Research conclusions
Patients with a low degree of primary tumor differentiation, multiple liver metastases (number of tumors > 4), and maximum diameter of liver metastases > 5 cm have a poor prognosis. Surgical treatment is the first choice for liver metastases, especially when liver metastases are close to great vessels.
Research perspectives
Radical surgery is the first choice for the treatment of patients with liver metastases from colorectal cancer. At the same time, multidisciplinary diagnosis and treatment should be discussed and combined with the actual situation to develop the most suitable treatment plan for the patient.
