Hepatectomy for liver metastasis of colorectal cancer

Int J Colorectal Dis. 2009 Apr;24(4):419-25. doi: 10.1007/s00384-008-0619-5. Epub 2008 Dec 19.

Abstract

Objective: The objective of this study was to investigate whether hepatic resection (HR) can increase the survival of liver metastasis of colorectal cancer (CRC).

Materials and methods: CRC patients (n=669) with liver metastasis treated at the Zhongshan Hospital, Fudan University from 1/2000 to 7/2007 were included in the study to investigate the relationship between HR and cancer survival.

Results: CRC patients (n=669) with liver metastases who had primary tumor resection were grouped in synchronous liver metastasis (SLM; 56.7%, n=379) and metachronous liver metastasis (MLM) groups (43.3%, n=290). Hepatic resection rates were lower (32.5%, n=123) in the SLM than the MLM group (44.8%, n=130, P<0.05). The 30-day mortality rate in the MLM (2.3%) was significantly lower than SLM (2.4%) groups. The 5-year survival rates (36.6%) was same compared to SLM group (33.1%, P>0.05). One-, 2-, and 3-year survival of stages I and II operation cases were 92.5% vs 86.5%, 0.7% vs 58.0%, and 42.1% vs 44.9% (P>0.05) in the SLM group, respectively. Recurrence after first hepatic resection associated with a 2.23-fold increased risk of death (P<0.01). Incision margins larger than 1 cm and HR for recurrence associated with 34% and 27% (P<0.05) decreased death risk.

Conclusions: Hepatic resection could help the survival of liver metastasis of colorectal cancer, and stage I surgery is safe for this disease.

MeSH terms

  • Colorectal Neoplasms / pathology*
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Proportional Hazards Models
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Time Factors