Prognostic analysis of colorectal cancer patients with synchronous liver metastasis

Objective To investigate the clinicopathological characteristics of colorectal cancer with synchronous liver metastasis,and analyze its prognostic factors.Methods Clinical data of 231 colorectal cancer patients with synchronous liver metastasis who were admitted in the First Affiliated Hospital of Sun Yat-sen University from August 1994 to December 2009 were analyzed retrospectively.The relationship between clinicopathological parameters and prognosis was investigated.Results The patients with synchronous liver metastasis accounted for 8.46% of total 2732 colorectal cancer patients.The overall 1,3 and 5-year survival rates of 231 patients with synchronous liver metastasis were 70.2%,21.9% and 11.4% respectively.The median survival time was 19 months.Univariate analysis revealed that tumor circumference,serosal invasion,stage of liver metastasis,invasion depth,tumor differentiation,surgical method and chemotherapy affected the patients' prognosis.The overall 1,3,5-year survival rates of the patients with H1 metastasis were 88.4%,39.7% and 21.3%,with H2 stage 64.1%,15.7% and 7.8%,with H3 stage 55.0%,9.2% and 0.0%,respectively(P0.01).The 1,3,5-year survival rates of the patients with radical resection were 84.6%,37.9% and 19.8%,with palliative resection 60.2%,24.0% and 0.05%,with non-resection procedures 37.0%,0.09% and 0.0%(P0.01).Multivariate analysis revealed that only stage of liver metastasis and surgical method were independent prognostic factors for colorectal cancer patients with synchronous liver metastasis.Conclusions Stage of liver metastas is and radical resection are most important prognostic factors for colorectal cancer patients with synchronous liver metastasis,thus early detection and radical surgery for primary tumor together with liver lesion are necessary for the patients without extra-hepatic metastasis.Chemotherapy can improve survival time of the patients after palliative surgery.