Abstract
Background and AimsMucinous colorectal cancer has traditionally been associated with high rates of recurrence and poor long-term survival. There is limited published data on outcomes for patients undergoing liver resection for metastatic mucinous colorectal cancer. The aim of this study was to compare the clinicopathological outcomes for patients with mucinous colorectal cancer liver metastases (CRCLM) undergoing liver resection to a matched group of patients with adenocarcinoma not otherwise specified (NOS) and to evaluate the accurary of preoperative magnetic resonance imaging (MRI) at detecting the presence of mucin in liver metastases.Materials and MethodsPatients with mucinous CRCLM undergoing liver resection were matched 1:3 to patients with adenocarcinoma NOS CRCLM. Clinicopathological data from the primary tumour and metastatic lesion were collected and compared between the groups. Hepatic recurrence-free, disease-free and overall survival were compared between the groups. The ability of preoperative MRI to detect mucin in CRCLM was also evaluated.ResultsA total of 25 patients with mucinous CRCLM underwent surgery over the 12-year period and were matched to 75 patients with adenocarcinoma NOS. Clinicopathological findings were similar between the groups. Resection of mucinous CRCLM was feasible and safe with similar levels of morbidity to adenocarcinoma NOS. There were no differences identified in hepatic recurrence-free (p=0.85), disease-free (p=0.25) and overall survival (p=0.98) between the groups. MRI had a sensitivity of 31.3% in detecting the presence of mucin in CRCLM.ConclusionPatients with mucinous CRCLM in this study had similar outcomes to patients with adenocarcinoma NOS. Based on our findings, histological subtype should not be taken into account when deciding on resectability of CRCLM.
Highlights
Resection of colorectal cancer liver metastasis (CRCLM) has become the standard of care in patients who are physiologically suitable with potentially curable disease and is typically associated with 5-year overall survival rates of 25-40%, but as high as 58% in some series [1–3]
A total of 25 patients underwent resection of mucinous CRCLM during the study period and these patients were matched with a group of 75 patients who underwent liver resection for CRCLM derived from adenocarcinoma not otherwise specified (NOS)
Based on our single institution data, resection of CRCLM derived from mucinous adenocarcinoma appears to be feasible, safe and associated with similar oncological outcomes to that of adenocarcinoma NOS
Summary
Resection of colorectal cancer liver metastasis (CRCLM) has become the standard of care in patients who are physiologically suitable with potentially curable disease and is typically associated with 5-year overall survival rates of 25-40%, but as high as 58% in some series [1–3]. There has been some discussion regarding the ability of preoperative imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging (MRI) to determine whether or not a CRCLM contains mucin [21, 22]. There is limited published data on outcomes for patients undergoing liver resection for metastatic mucinous colorectal cancer. The aim of this study was to compare the clinicopathological outcomes for patients with mucinous colorectal cancer liver metastases (CRCLM) undergoing liver resection to a matched group of patients with adenocarcinoma not otherwise specified (NOS) and to evaluate the accurary of preoperative magnetic resonance imaging (MRI) at detecting the presence of mucin in liver metastases
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