Colorectal liver metastasis post hepatic resection: outcomes and prognostic factors study

Abstract

Background: Management of patients with colorectal liver metastasis (CLM) is complex and the surgical decision process should be based on a comprehensive oncologic strategy. The study intends to review the outcomes of the patients who underwent colorectal liver metastasectomy and identify related prognostic factors. Methods: Patients who underwent liver resection from January2010-December2016 were recruited. Demographic and clinical characteristics, staging, treatment modality, disease progression, morbidity and 90-day mortality data were collected and analyzed. The overall survival analysis was performed using Kaplan-Meier method. Results: 70patients underwent colorectal liver metastasectomy. Two-third had synchronous liver metastases during the initial presentation. The 90-day mortality was 2.8 %.One-third recovered with no complication while half developed complications but amenable solely to pharmacological treatment. 50% patients survived through 21 months post-operatively(1-85 months) with a 5-year survival rate of 55.6%. Up to half developed recurrence during the follow up.Recurrence occurred within first year in 35% of patients and after 3 years in 13% of patients respectively. There was no obvious factor prognosticating disease recurrence in this cohort. However, interestingly, those with tumour size between 7-30 cm3 have lower risk of disease recurrence as compared to those with tumour size < 7cm3. Recurrence of CLM is the only prognosticating factor for overall survival. Those with recurrent disease have significantly 3.5 times higher risk of dying as compared to those without recurrent disease. Conclusion: Liver resection should be considered in all suitable patients in order to improve their survival outcome. A close monitoring is imperative in view of early recurrence.