Surgical treatment of liver metastases from colorectal cancer: experience of a single institution.

Abstract

This report analyses an experience with 42 liver resections for metastatic colorectal carcinoma. Forty-two patients underwent curative resection for liver metastasis from colorectal cancer between January 2004 and December 2007, with a follow up period that ranged from 3 to 66 months. In this retrospective study, early postoperative 30 day mortality and morbidity in addition to the effects of Dukes' stage, type of resection, number and size of the tumor, synchronous or metachronous metastases, resection margin, sex, age and chemotherapy protocol on three year survival were analyzed retrospectively. Univariate analyses of survival were estimated using the Kaplan-Meier method. Multivariate analysis was evaluated using Cox regression method. The value of P<0.05 was accepted as significant. Early postoperative morbidity and mortality rates were 7.14% and 0%, respectively. Fourteen patients died during the follow-up period of 3 to 66 months (mean, 40.40±12.87). Median survival was 56 months and three year survival rate was 71.30%. Recurrence occurred in 11 patients (26.00%) after liver resection and additional surgery was performed for two of them. At univariate analysis, the number of tumors (<4), tumor size (<4 cm), type of resection and negative resection margins were significantly correlated with three year survival. Sex, age, Dukes' stage, synchronous or metachronous metastasis, recurrence and chemotherapy protocol were not predictive of long-term prognosis. Multivariate analysis revealed that tumor size>4 cm and presence of more than four tumors before surgery were associated with a 5.89 and 2.18-fold increased risk of death, respectively. Curative resection is one of the most important treatment options that can demonstrate long-term survival for patients.