Surgical treatment for better prognosis of patients with liver metastases from colorectal cancer

Hepatogastroenterology. 2007 Sep;54(78):1805-9.

Abstract

Background/aims: Hepatic resection is established as the best available treatment for colorectal cancer metastases to the liver, but the optimal procedure for the resection is now controversial. In this study we retrospectively evaluated the influence of the selection of surgical procedures for hepatic resection in determining the prognostic factors.

Methodology: A population of 111 patients with liver metastases from colorectal cancer underwent initial and radical hepatic resection. Survival rates as a function of clinical, primary tumor pathologic TNM classification and surgical determinates were examined retrospectively with univariate and multivariate analyses.

Results: The overall, 1-, 3-, 5- and 10-year survival rates were 85.5%, 51.4%, 41.6% and 30.9%, respectively. Patient survival was uncorrelated with any of the following factors: sex, age, temporal relationship, primary tumor site, tumor stage, pathological depth, pathological vascular invasion, pathological lymphatic invasion and pathological lymph node metastases of the primary tumor, maximum diameter of liver lesions, intrahepatic distribution patterns, type of hepatectomy, and number of hepatectomies. However, the number of liver tumors and the tumor-free margins were significantly associated with good prognosis.

Conclusions: Safe hepatectomy with adequate tumor-free margins leads to a better prognosis.

MeSH terms

  • Adult
  • Aged
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery*
  • Digestive System Surgical Procedures / methods*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prognosis
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome