[Surgical treatment for liver metastasis of colorectal cancer: a report of 59 cases].

BACKGROUND & OBJECTIVE: Liver metastasis is the major cause of treatment failure of colorectal cancer. The median survival time of patients with untreated liver metastases is only about 6 months. Surgical resection is the major treatment to prolong survival time of the patients. This study was to assess surgical treatment efficacy on these patients and their prognosis.

METHODS

Records of 59 colorectal cancer patients with liver metastases, treated with hepatectomy (including 14 cases of anatomical segmentectomy and 45 cases of wedge resection) from Jan. 1987 to Dec. 1998 in Cancer Hospital of Chinese Academy of Medical Sciences were reviewed. Postoperative complications occurred in 4 (6.8%) patients, without surgical death. Survival rate was estimated by Kaplan-Meier method, and compared by log-rank test. Prognostic factors were analyzed by multivariate Cox regression model.

RESULTS

The overall 1-, 3-, and 5-year survival rates were 91.4%, 34.8%, and 21.9%. Survival rate was significantly lower in patients with heterochronia metastasis than in patients with synchronal metastasis (P < 0.05), and lower in patients with metastasis size of > 5 cm than in patients with metastasis size of < or = 5 cm. Univariate analysis showed that time of liver metastasis and metastasis size of > 5 cm were prognostic factors (P < 0.05); while node status of primary tumor, number of liver tumors, and carcinoembryonic antigen level had no significant relations with prognosis (P < 0.05).

CONCLUSIONS

Hepatectomy may prolong survival time of colorectal cancer patients with liver metastases. Early diagnosis with intensive follow-up is crucial to increase the resectability of liver metastasis.