研究背景：结直肠癌是临床常见恶性肿瘤，肝脏是结直肠癌最好发的转移部位，在结直肠癌患者中，2/3死因与肝转移相关，因此，对于结直肠癌肝转移的诊治尤为重要。目前有关于结肠癌原发灶位置与CRCLM术后长期生存相关性的研究。本文旨在研究原发于左半及右半结肠的CRCLM患者在DFS以及OS上的差异，并分析预后相关因素。
研究方法：回顾性分析北京协和医学院中国医学科学院肿瘤医院2009-2016年行根治性治疗（包括联合射频消融治疗）的结肠癌肝转移患者的诊断、治疗及预后等临床资料。将原发灶位于乙状结肠、降结肠、脾曲的患者归为左半结肠组，位于盲肠、升结肠、横结肠的患者归为右半结肠组，利用统计学软件SPSS v20进行统计学分析，比较两组的生存差异，并分析其预后因素。
研究结果：共有97例患者纳入本研究，原发于左半结肠65例、右半结肠32例，两组患者除接受新辅助化疗比例外，余临床病理特征无明显差异。全部患者中位无瘤生存时间（DFS） 9.0月，中位总生存时间（OS） 41.0月，左、右半结肠组中位DFS分别为 6.0月和9.0月，两者无统计学显著性差异（P=0.579）。左、右半结肠组中位OS（54.0月VS 33.0月） 及5年生存率（ 34.8% VS 17.4%），亦无统计学显著性差异（P=0.270）。单因素分析术前CA19-9、术前CEA、是否接受新辅助化疗、肝转移灶数量≥4与患者DFS有关，仅肝转移灶≥4是OS的危险因素。
结论：本研究结果表明肝转移灶数量是结肠癌肝转移术后影响总生存的独立预后因素。与右半结肠癌肝转移相比，左半结肠癌肝转移患者行根治性治疗术后DFS更短，OS延长，但均未达到统计学显著性差异。

Background and objective：Colorectal cancer is a common malignant tumor, liver is the most likely metastasis organ.Two-thirds of the cause of death associated with liver metastasis. Now there is few study focused on the relationship of colon cancer primary location and long-term survival after radical resection of CRCLM .The purpose of this study is to research the differences of DFS and OS in patients with left and right hemicolon CRCLM.
Methods: 97 CRCLM patients undergoing resection between 2009-2016 were retrospectively analyzed in cancer hospital ,Peking union medical college & Chinese academy of medical sciences.Primary tumors located in the cecum, ascending colon,and transverse colon were defined as right-sided tumors group, while tumors located in the splenic flexure, descending colon, and sigmoid colon were defined as left-sided tumors group. Clinical pathologic characteristics and the survival data were analyzed by using SPSS v20.
Results: A total of 97 patients were included in this study, including both left hemicolon (n = 65) and right hemicolon (n = 32) primary. Total median DFS of the two groups is 9.0 months and median OS 41.0 months. Except the status of neoadjuvant chemotherapy, there were no differences between two groups on clinical pathological characteristics. There is no statistical significant difference of DFS and OS between the left hemicolon group and the right hemicolon group(6.0 VS 9.0 months,(P = 0.579)), as well as the OS and 5 year survival rate(54.0 months vs 33.0 months,34.8% vs 17.4%,P = 0.270).Single factor analysis indicated that CA19-9, CEA, the status of new adjuvant chemotherapy, 4 or more liver metastases number were risk factors of DFS, but none of them were independent risk factors. 4 or more liver metastases was independent risk factor of OS.
Conclusion：In this Study, the number of liver metastases is the prognostic factor of OS. left and right hemicolon cancer liver metastases. There is a trend of OS benefit of left hemicolon cancer group compared with right hemicolon cancer group, while it did not reach statistic significant difference partially because of the limited sample size.