Efficacy and survival prognosis analysis of surgical resection combined with targeted therapy in patients with colorectal cancer liver metastasis

手术切除联合靶向治疗治疗结直肠癌肝转移患者的疗效和生存预后分析

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Abstract

INTRODUCTION: Colorectal cancer liver metastasis (CRLM) is a leading cause of death in colorectal cancer patients. Simple surgical resection has a high recurrence rate, and combining targeted therapy offers a new way to improve prognosis. Currently, the efficacy of surgery combined with targeted therapy and the influencing factors of prognosis still require in-depth exploration. METHODS: From January 2019 to February 2022, 76 CRLM patients were randomly split into an observation group (n=38, surgery + chemotherapy + bevacizumab-based targeted therapy) and a control group (n=38, surgery + conventional chemotherapy). Key indicators were compared, and Cox regression analyzed prognosis factors. RESULTS: There were no significant differences in operation time (185.6±32.4 min vs. 178.9±29.5 min) or intraoperative blood loss (210.3±56.7 ml vs. 205.8±51.2 ml) between groups (P>0.05). However, the observation group had a shorter hospital stay (10.2±2.1 days vs. 12.5±2.6 days, P<0.05), higher ORR (68.9% vs. 46.7%) and DCR (91.1% vs. 75.6%, both P<0.05), and better 1-, 2-, 3-year PFS (72.2%/45.6%/31.1% vs. 51.1%/26.7%/15.6%) and OS (86.7%/64.4%/48.9% vs. 71.1%/42.2%/27.8%, all P<0.05). The observation group also had a higher hypertension rate (23.3% vs. 6.7%, P<0.05), with no other significant adverse reaction differences (P>0.05). Cox regression showed targeted therapy and ≤3 liver metastases were independent factors for favorable prognosis (P<0.05). DISCUSSION: Surgical resection combined with targeted therapy can effectively improve tumor control efficacy and long-term survival outcomes of CRLM patients, and shorten the hospital stay. Although this combined regimen increases the risk of hypertension, its overall safety is controllable.

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