Resection of hepatic metastatics from colorectal carcinoma. Factors related with recurrence and disease-free survival

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Background: Surgery has become the standard treatment for patients with stage IV colorectal carcinoma and liver metastasis. Methods: From 2010-2015: 158 patients with liver metastases (142 CRC metastases that). We analyzed long-term results,actuarial survival and DFS, and compared risk factors with log-rank and chi-square (significance level p <0.05). Results: 72 metachronous (51%) and 70 synchronous metastases: 14 simultaneous resection, 14 liver-first, and colon-liver resection in 60% . With a mean follow-up of 23.7±16 months presented tumor recurrence 53(46.5%). At end, 55 patients were alive without tumor recurrence (41%). DFS at 1, 3 and 5 years is 65%, 37.9% and 32.1%, respectively, with an mean DFS interval of 33.6±2.96 months. Variables related to the recurrence: bilobar or segment I location,inverse surgery, second hepatectomies, presence of vascular invasion and R1 resection . Variables related to DFS: multicentric tumors, reverse surgery, rehepatectomies, vascular invasion and R1 resection. The use of preoperative chemotherapy, the type of resection or the need for transfusion has not been linked to long-term results. Conclusion: Resection of CCR hepatic metastases is the treatment of choice with 5-year DFS about 32% and mean DFS of 34 months. Initial hepatic resection in synchronous metastases has been associated with worse DFS as well as second resections. Neither the type of resection (major hepatectomy or atypical resection) nor the use or not of preoperative chemotherapy have been related to recurrence.