Socioeconomic Deprivation Does Not Affect Short or Long Term Outcomes after Liver Resection for Colorectal Liver Metastases

Abstract

Introduction: Socioeconomic deprivation (SED) is a well documented factor in poor outcomes following treatment for many primary cancers. We sought to examine if this is true for liver resections for colorectal liver metastases (CRLM). Methods: We did a retrospective study on a prospectively held database at Cardiff Liver unit on all patients having liver resections for CRLM between January 2013 and December 2018. Data was censored at 30 June 2019 or death. Demography, ASA status, length of stay, morbidity, mortality, margin status, vascular and bile duct invasion, tumour burden score and deprivation status (using Welsh Index of Multiple Deprivation (WIMD) recorded. WIMD 1 is most deprived and 5 least deprived. We combined the quintiles 1&2 and 3&4 to compare deprived vs non deprived patients. Results: 337 resections were perfomed in 275 patients. Males 66%. Median age 66(21-93), median hospital stay 7 days (2-216) and 90 day mortality of 2.4%. The overall survival(OS) was 90%, 70% and 52%. There was no difference in the baseline characterestics between the most (Q1&2) and least(Q3&4) deprived patients. The OS at 1,3,5 years for most and least deprived were 90%, 69%, 45% and 96%,72% and 60% respectively (P=0.26). There was no difference in the hospital stay, morbidity and mortality between the two groups. Only tumour burden and two stage procedure led to significantly poorer long term outcome. Conclusion: SED does not appear to affect OS after liver resection for CRLM. However, this needs to be confirmed in a larger cohort to avoid Type II error.