Factors Affecting Survival Rate Following Hepatic Resection for Metastatic Colorectal Cancer

Jin, Seon O; Lee, Kil Yeon; Lee, Sang Mok; Park, Ho Chul; Koh, Suk Hwan; Oh, Soo Myung; Yoon, Choong; Hong, Sung Wha

Abstract

BACKGROUND/AIMS
A hepatectomy for liver metastases from colorectal cancer has recently received general acceptance as a safe, potentially curative treatment modality due to its low surgical mortality and significant improvement of survival rates after resection. However, criteria for the selection of patients and treatment modalities remains controversial. The aim of study was to determine the prognostic factors. in patients who had undergone a hepatic resection for metastatic colorectal cancer. METHODS: Twenty-four patients who had underdone initial hepatic resection for liver metastases from colorectal cancer between 1992 and 2002 were analyzed with regard to clinical and pathological parameters. The survival rate was calculated using the Kaplan-Meier method and Cox regression hazard model. The mean follow up period was 37 months. RESULTS: The overall 5-year survival rate was 29.3%, with a mean survival of 39 months. There were 10 (41.3%) and 14 (58.7%) cases of synchronous and metachronous metastasis, respectively. The 5-year survival rate was shown to be significantly lower in patients with more than 4 metastases (p=0.01), bilobar metastasis (p=0.02) and vascular invasion (p=0.01). The number of hepatic metastases (p= 0.02) has been demonstrated as an independent factor for the 5-year survival. CONCLUSION: Patients with multiple, bilobar hepatic metastases and vascular invasion demonstrated a poor survival rate. Therefore, in patients with poor prognostic factors, curative surgical resection, accompanied by a multimodality treatment, is necessary for an improved survival.