Prognostic influence of multiple hepatic metastases from colorectal cancer

Malik, H Z, Hamady, Z Z R, Adair, R, Finch, R, Al-Mukhtar, A, Toogood, G J, Prasad, K R and Lodge, J P A (2007) Prognostic influence of multiple hepatic metastases from colorectal cancer. European Journal of Surgical Oncology, 33 (4), 468-473. (doi:10.1016/j.ejso.2006.09.030).

Abstract

AIMS: The aim of this study was to report the results of surgery for multiple colorectal liver metastases on patient outcome.

METHODS: This was a review of 484 consecutive patients who underwent liver resection for colorectal liver metastases between 1993 and 2003. The cohort was divided into 2 groups, those with 1-3 metastases and those with "multiple" metastases, namely 4 or more lesions. The later group was subdivided into those with less than 8 ("several") or 8 or more ("numerous") separate lesions.

MAIN OUTCOME MEASURES: the post-operative hospital stay was calculated and morbidity and mortality were assessed.

RESULTS: On multivariate analysis the presence of multiple metastases was the only predictor for both poorer overall survival (p=0.007) and disease-free survival (p=0.031). However, when patients with multiple metastases are analysed in detail this survival disadvantage appears to be only present in patients with numerous (8 or more) lesions.

CONCLUSION: Although patients with multiple metastases appear to have a poorer outcome, significant number of patients with multiple metastases survive to 5 years or more and should not be denied surgery. Patients with numerous (8 or more) metastases showed a poorer survival disadvantage. These patients need alternative treatment speculatives.

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Contributors

Author: Z Z R Hamady

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