Clinical Prognostic Factors for Survival in Patients with Resectable Colorectal Liver Disease

Abstract

Introduction: The study aims to investigate the characteristics of the liver metastasis and their association with the overall survival in patients with colorectal liver metastases (CRLM) undergoing curative resection. Methods: All patients undergoing curative hepatectomy for CRLM from 2010 to August 2018 were collected, of 171 consecutive patients identified, 157 were deemed eligible for analysis. Univariate analysis was performed with Kaplan-Meier method and the log-rank test, in order to determine the influence of variables on overall survival (OS). For multivariate analysis, Cox proportional hazard regression model was used to pinpoint the variables associated with OS. Results: In univariate analysis, neoadjuvant chemotherapy (p=0,021), bilobar disease (p=0,014), larger metastasis than 4cm (p=0,007), number of metastasis >1cm (p=0,034), intraoperative blood transfusion (P=0,026), positive margin resection (p=0,010), and Clavien-Dindo grade >3 postsurgical complications (p=0,010) were associated with significantly shorter OS. Multivariate analysis showed that neoadjuvant chemotherapy was a predictor of compromised survival [HR of 1.61, 95% CI 1.03-2.15 (p=0.034)]. For characteristic related to the pathological outcomes, positive margin resection [HR of 2.37, 95% IC 1.40-4.01 (p=0.001)] was associated with poor OS. In the case of postsurgical factors, Clavien-Dindo grade >3 [HR of 2.348, 95% CI 1.30-4.22 (p=0.004)] showed to be a risk factor for worse OS. Conclusion: Prehepatectomy chemotherapy, positive margin and Clavien-Dindo grade >3 revealed to have a negative impact on overall survival for patients with resectable CRLM. These factors should be taken into consideration when selecting treatment strategies in CRLM.