Background/Objectives: Colorectal cancer (CRC) with hepatic (CRLM) and pulmonary metastases (CRLU) presents a significant clinical challenge, leading to poor prognosis. Surgical resection of these metastases remains controversial because of limited evidence supporting its long-term benefits. To evaluate the impact of surgical resection of both hepatic and pulmonary metastases on long-term survival in patients with multivisceral metastatic colorectal cancer, this retrospective cohort study included 192 patients with UICC stage IV CRC treated at a high-volume academic center. Methods: Patients were divided into two groups: those who underwent surgical resection of both hepatic and pulmonary metastases (n = 100) and those who received non-surgical treatment (n = 92). Propensity score matching was used to adjust for baseline differences. The primary outcome was overall survival (OS). Results: Unadjusted analysis showed a significant OS benefit in the surgical group (median OS: 6.97 years) compared with the conservative group (median OS: 2.17 years). After propensity score matching, this survival advantage persisted (median OS: 5.58 years vs. 2.35 years; HR: 0.3, 95% CI: 0.18–0.47,p< 0.0001). Conclusions: Surgical resection of hepatic and pulmonary metastases in multivisceral metastatic CRC significantly improves long-term survival, supporting an aggressive surgical approach in selected patients.
背景/目的：结直肠癌（CRC）伴肝转移（CRLM）和肺转移（CRLU）构成显著的临床挑战，常导致不良预后。由于支持其长期获益的证据有限，对这些转移灶的手术切除仍存争议。为评估肝肺转移灶手术切除对多脏器转移性结直肠癌患者长期生存的影响，本回顾性队列研究纳入192例在大型学术中心接受治疗的UICC IV期CRC患者。方法：将患者分为两组：接受肝肺转移灶手术切除组（n=100）和接受非手术治疗组（n=92）。采用倾向评分匹配校正基线差异。主要结局指标为总生存期（OS）。结果：未校正分析显示手术组较保守治疗组具有显著OS获益（中位OS：6.97年 vs 2.17年）。经倾向评分匹配后，该生存优势持续存在（中位OS：5.58年 vs 2.35年；HR：0.3，95% CI：0.18–0.47，p<0.0001）。结论：对多脏器转移性结直肠癌患者实施肝肺转移灶手术切除可显著改善长期生存，支持在特定患者中采取积极的手术治疗策略。
肿瘤(癌症)患者之家