Long-Term Survival after Liver Resection for Colorectal Liver Metastases: A Retrospective Single-Centre Study with 10-Year Follow-Up

Abstract

Introduction: Hepatic resection is the curative treatment for colorectal liver metastases (CRLM). The reporting of 10-year survival data is important for assessment of cure rates, frequency and outcomes of late recurrences. The aim of this study was to assess ten-year survival of patients undergoing liver resection at a single centre. Methods: Liver resections for CRLM performed between 1995 and 2008 with follow-up to 2018 were retrospectively reviewed. Demographic, clinicopathological and survival data were analysed. The Fong clinical risk score was dichotomised into low (0-2) and high (3-5) risk and ten-year survival was the primary outcome measure. Kaplan Meier curves and Cox regression were used to analyse factors associated with 10-year survival. Results: A total of 1120 patients underwent liver resection for CRLM. The median age was 68 (range 23-91) years. Synchronous disease was present in 50%, with 56% of patients having adjuvant chemotherapy after primary colorectal cancer resection. 29.4% had a high Fong score (3-5) with 15.4% of patients having repeat liver resections for recurrent metastases. The median post-operative survival was 2 years. Overall ten-year survival was 12.3%. Fong risk classification had a statistically significant association (p=0.006, 95% CI 0.706 - 0.943) with ten-year survival. 2.6% (n=29) of patients with Fong score 3-5 were alive at 10 years. Conclusion: In this single center analysis the ten-year survival rate for resection in CRLM was 12.3%. Patients with high Fong clinical risk score have poorer long-term outcomes. Therefore, further trials are required to assess the benefit of additional treatment such as chemotherapy.