关键词: 结直肠肿瘤, 肝转移, 倾向性匹配分析, 危险因素

Abstract:

Objective To analyze independent risk factors for liver metastasis in colorectal cancer based on the SEER database. Methods A total of 60, 136 colorectal cancer patients from the SEER database between 2010 and 2019 were included, among whom 5, 072 developed liver metastases. Propensity score matching(PSM)(1∶1) was used to balance the baseline clinical characteristics between the liver metastasis and non-metastasis groups, resulting in a matched cohort of 9, 716 patients with 4, 858 cases in each group. Univariate logistic regression analysis was applied both before and after matching the identified risk factors for liver metastasis. Results Before matching, univariate logistic regression analysis identified 12 factors(age, sex, race, T stage, N stage, radiotherapy, chemotherapy, brain metastasis, bone metastasis, lung metastasis, distant lymph node metastasis, and other rare site metastases) as independent risk factors for liver metastasis. After matching, chemotherapy and metastasis to other rare sites were identified as protective factors against liver metastasis in colorectal cancer(OR<1), while bone and lung metastases were independent risk factors. Additionally, among primary tumor sites, the highest incidence of liver metastasis was observed in the transverse colon(9.86%), followed by the rectosigmoid colon(8.91%). Conclusion The importance of chemotherapy as a protective factor against liver metastasis in colorectal cancer should be highlighted. For colorectal cancer patients who have already developed bone or lung metastases, enhanced monitoring and intervention for liver metastasis are essential to develop personalized treatment strategies and improve the prognosis.

Key words: colorectal neoplasms, liver metastasis, propensity score matching, risk factors