Dissertations & Theses (Open Access)

Date of Award

12-2020

Degree Name

Master of Science (MS)

Advisor(s)

Ashraf Yaseen

Second Advisor

Ruosha Li

Third Advisor

Michael Cannell

Abstract

Background- Colorectal cancer is the third most common cancer in the world. I investigated the survival rates among colorectal cancer patients diagnosed with hepatic metastasis to see if any variables are associated colorectal risk and survival. Methods- Patients were diagnosed from 2000-2019 and collected through MD Anderson’s database. A descriptive analysis, univariate analysis, Kaplan-Meier with Mantel log-rank test, Cox proportion hazard regression and a Stratified Cox Model was performed to investigate death. A competing risk regression was implemented to investigate liver recurrence. Results- There was a clear difference in the survival outcome between liver surgery patients and non-liver surgery patients with a 99.1% two-year survival rate for the surgery group and a 47.1% two-year survival rate for the non-liver surgery group. Though the survival rate is higher for the 220 liver surgery patients, liver recurrence did occur out of 161 patients and 36 of them has died by end of follow-up. Age of liver diagnosis, extrahepatic metastasis, size path, synchronous, right colon primary, bilateral metastasis, and the number of liver

metastasis were significantly associated with worse survival. Liver surgery, primary surgery, and BMI were significantly significant with a greater overall survival in univariate analyses. The results competing risk regression showed that the log number of liver metastasis (SHR: 1.30, 95% CI: 1.07-1.35) and node positive (SHR: 1.42, 95% CI: 1.08-1.86) were significantly associated with a poorer result for liver recurrence. Conclusions- Resection of the liver and primary cancer is an optimal way to treat patient with colorectal cancer with colorectal cancer with liver metastasis. It is important to note that even if a patient elects to go through surgery, there is a strong chance that recurrence will happen. There is also a significant difference in the survival outcome between the patients who diagnosed with adenocarcinoma of the right colon.

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