转化为简体中文并保留原句结构：转移性结直肠癌患者的生存率在二十年内有所提高。
Survival improvement for patients with metastatic colorectal cancer over twenty years.
发表日期：2023 Feb 13
作者：
Fadl A Zeineddine, Mohammad A Zeineddine, Abdelrahman Yousef, Yue Gu, Saikat Chowdhury, Arvind Dasari, Ryan W Huey, Benny Johnson, Bryan Kee, Michael S Lee, Maria Pia Morelli, Van K Morris, Michael J Overman, Christine Parseghian, Kanwal Raghav, Jason Willis, Robert A Wolff, Yoshikuni Kawaguchi, Jean-Nicolas Vauthey, Ryan Sun, Scott Kopetz, John Paul Shen
来源：
npj Precision Oncology
摘要：
在过去的二十年中，转移性结直肠癌（CRC）连续临床试验的中位总生存期在对照组和实验组方面均稳步改善。但是，未进行试验治疗的转移性CRC患者的生存增量尚未定量化。我们对在2004年至2019年期间在德克萨斯大学M.D.安德森癌症中心（UTMDACC）接受一线治疗的1420名原发性转移性CRC患者进行了回顾性研究。对于2004年至2012年诊断的患者，中位总生存期大致稳定（22.6个月），但对于2013年至2015年和2016年至2019年诊断的患者，中位总生存期稳步改善（分别为28.8个月和32.4个月）。同样，五年生存率从2004年至2006年诊断的患者的15.7%增加到2013年至2015年诊断的患者的26%。值得注意的是，具有BRAFV600E突变或微卫星不稳定（MSI-H）肿瘤的患者的生存状况也有所改善。多元回归分析确定，外科切除肝转移（HR = 0.26，95% CI，0.19-0.37），使用免疫疗法（HR = 0.44，95% CI，0.29-0.67）和使用第三线化疗（regorafenib或trifluridine/tipiracil，HR = 0.74，95% CI，0.58-0.95），而不是诊断年份（HR = 0.99，95% CI，0.98-1），与更好的生存状态相关，表明这些疗法的增加是观察到的生存改善的驱动力。 © 2023.作者（们）。
Over the past two decades of successive clinical trials in metastatic colorectal cancer (CRC), the median overall survival of both control and experimental arms has steadily improved. However, the incremental change in survival for metastatic CRC patients not treated on trial has not yet been quantified. We performed a retrospective review of 1420 patients with de novo metastatic CRC who received their primary treatment at the University of Texas M.D. Anderson Cancer Center (UTMDACC) from 2004 through 2019. Median OS was roughly stable for patients diagnosed between 2004 and 2012 (22.6 months) but since has steadily improved for those diagnosed in 2013 to 2015 (28.8 months), and 2016 to 2019 (32.4 months). Likewise, 5-year survival rate has increased from 15.7% for patients diagnosed from 2004 to 2006 to 26% for those diagnosed from 2013 to 2015. Notably, survival improved for patients with BRAFV600E mutant as well as microsatellite unstable (MSI-H) tumors. Multivariate regression analysis identified surgical resection of liver metastasis (HR = 0.26, 95% CI, 0.19-0.37), use of immunotherapy (HR = 0.44, 95% CI, 0.29-0.67) and use of third line chemotherapy (regorafenib or trifluridine/tipiracil, HR = 0.74, 95% CI, 0.58-0.95), but not year of diagnosis (HR = 0.99, 95% CI, 0.98-1), as associated with better survival, suggesting that increased use of these therapies are the drivers of the observed improvement in survival.© 2023. The Author(s).