Abstract
Problem statement: Hepatic-only metastasis in colorectal cancer is not a rare clinical finding and can account for 30% of cases. However, only 10-25% of cases are suitable for hepatic resection as part of their treatment pathway. We sought to document our own findings by reviewing patients with hepatic-only disease. Approach: A retrospective analysis was designed to include all patients seen at our institution from 1st January 2000 until 30th June 2010 and information as derived from the patients’ records. Results: Forty-four (44) patients were found, with an average age of 60.8 years and a male preponderance. The majority of patients (approximately 57%) with hepatic-only metastases developed their disease following adjuvant therapy. Better overall survival was seen when a primary tumor had a low grade of histological differentiation and fewer than 3 hepatic lesions appreciated on conventional radiology. Better outcome was seen in patients who underwent hepatic resection. Conclusion: Patients with hepatic-only metastases are not uncommon within our institution. Hepatic resection afforded better outcome and compares favorably with published literature.
Highlights
Colorectal Cancer (CRC) is a relatively common malignancy and accounts for approximately 12.9% of all cancer cases diagnosed within the European Union (EU), it is associated with high mortality and represents almost 12.2% of all cancer deaths within the EU (Cutsem et al, 2010)
A retrospective analysis was designed to include patients referred within the period of 1st January, 2001 to 30th June 2010 to Mid-Western Regional Hospital (MWRH) and data was derived from several sources
The number of hepatic metastases was reviewed for the cohort and the majority of patients had less than 3 lesions at consideration for management and this is displayed in Table 2 and Fig. 4
Summary
Colorectal Cancer (CRC) is a relatively common malignancy and accounts for approximately 12.9% of all cancer cases diagnosed within the European Union (EU), it is associated with high mortality and represents almost 12.2% of all cancer deaths within the EU (Cutsem et al, 2010) Given these findings, the management of this disease and its full clinical spectrum from early stage to advanced stage is well studied and documented. Combined Modality Treatment (CMT) has led to an improvement in the median overall survival from 8-12 months of 18-24 months (Kopetz et al, 2009) This is a single institution review of our experience with the management of hepatic-only CRC, who were reviewed for surgical management of their hepatic metastases as part of their CTM; in which we document demographic information including age, sex and stage of presentation, systemic therapy options including chemotherapy and biological therapy, histopathological features, radiological findings, the incidence and outcome of cases involved.
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