Retrospective analysis of clinical and pathologic risk factors in liver resection for hepatic colorectal metastases

OBJECTIVE: To analyze the clinical and pathologic risk factors of surgical treatment for liver metastases from colorectal cancer. MATERIALS AND METHODS: The data on 98 patients who underwent liver resection for hepatic colorectal metastases were collected and analyzed retrospectively. RESULTS: Overall 1-, 3-, and 5-year survival rates after hepatectomy for metastases were 94.6%, 45.0%, and 22.3%, respectively. Gender, pathologic primary tumor stage, histologic differentiation, size of metastatic tumor, and type of metastases were not statistically significant prognostic factors (P > 0.05). The 5-year survival rate was significantly lower in patients with lymph node metastases from the primary site than that in patients without lymph node metastases (14.1% vs. 39.5%, P = 0.013); survival rate in patients with vascular invasion from the primary tumor was also significantly lower than in those without invasion (10.2% vs. 49.0%, P = 0.032). The survival rate in patients who had unilobar metastases was higher than that in patients who had bilobar metastases (25.3% vs. 0%, P = 0.012). The 5-year survival rates in solitary metastasis, two to three metastases, and with the transfer number ≥4 were 29.1%, 14.4%, and 0%, respectively (P = 0.019). Multivariate analysis revealed resection margin, distribution of metastases, and the number of metastases as the independent risk factors associated with the overall survival rates (P = 0.044, 0.037, and 0.005, respectively). CONCLUSIONS: Surgical resection may be the only treatment modality for the cure of colorectal liver metastases. Negative resection margin, metastases confined to unilobar type, and number of metastases ≤3 are associated with better prognosis.