Improved Surgical Management of Colorectal Liver Metastases: A population-based retrospective analysis of 5773 cases in Southern Germany

Abstract

Background: Purpose of this study was to analyze the development of the surgical management of colorectal liver metastases (CLM) over a period of 10 years as well as the long-term clinical outcome of patients with CLM using data from a regional German tumour registry. Methods: Retrospective analysis of 5773 patients diagnosed with colorectal adenocarcinoma between 2002 and 2007 in Southern Germany. Observation was continued until 2012. Results: In total, 1355 patients (23.5%) had or developed CLM. Hepatic resection for CLM was performed in 357 patients (26.3% of CLM patients; 6.2% of all patients). Patients without CLM had a significantly better 5-year survival (58%) and 10-year survival (32%) than patients with liver metastases (14% and 6% respectively). Resection rates of CLM increased from 18% in 2002 to > 30% in 2006 and later with a significant increase in overall survival in resected CLM patients (up to 42% 5-year survival, 28% 10-year survival). Conclusions: The present study shows a significant improvement of the surgical management of colorectal liver metastases diagnosed from 2002 until 2007 in Southern Germany. However, no hepatic surgery was performed in up to 48% of potentially resectable CLM. The reasons for this relevant undertreatment need to be discussed in an interdisciplinary fashion between medical and surgical oncologists.