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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 8/2010

01-08-2010 | Original Article

Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases

Authors: Jung Wook Huh, Chol  Kyoon Cho, Hyeong Rok Kim, Young Jin Kim

Published in: Journal of Gastrointestinal Surgery | Issue 8/2010

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Abstract

Purpose

This study was designed to evaluate the impact of resection for primary colorectal cancer on oncologic outcomes in patients with synchronous colorectal liver metastases.

Methods

A retrospective analysis was performed on 91 consecutive patients with synchronous colorectal liver metastases who underwent resection of the primary colorectal cancer between December 1999 and December 2007. Of the 91 patients, 54 (59.3%) also underwent complete (R0) resection for liver metastases, and 84 (92.3%) received postoperative chemotherapy. The oncologic outcomes and prognostic factors were analyzed.

Results

Operative mortality was 1.1%, and morbidity was 37.4%. The 3- and 5-year overall survival rates were 44.5% and 26.8%, respectively. A multivariate analysis revealed that residual disease after surgery (non-R0 resection; p = 0.003), lymph node metastasis of the primary tumor (p = 0.015), and no postoperative chemotherapy (p = 0.001) were independent prognostic factors for poor survival. Independent predictors of an inability to achieve a complete resection were the presence of three or more liver metastases and the presence of extrahepatic disease at exploration. Significant differences in survival existed among the three risk stratification groups (no-, low-, and high-risk groups; p < 0.001).

Conclusions

The inability to safely render the liver and colon microscopically free of disease should cause a surgeon to reconsider synchronous colectomy and hepatectomy. A multidisciplinary approach that combines both complete resection of synchronous colorectal liver metastases and postoperative chemotherapy may achieve improved survival in patients with synchronous colorectal liver metastases.
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Metadata
Title
Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases
Authors
Jung Wook Huh
Chol  Kyoon Cho
Hyeong Rok Kim
Young Jin Kim
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 8/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-010-1250-7

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