Predictors of long-term survival in patients with hepatic resection of colorectal metastases: Analysis of a Brazilian Cancer Center Cohort

J Surg Oncol. 2020 Apr;121(5):893-900. doi: 10.1002/jso.25893. Epub 2020 Mar 9.

Abstract

Background: Hepatic metastases are a major cause of death in patients with colorectal cancer. A comprehensive assessment of the prognostic factors associated with long-term survival could improve patient selection for surgical approaches and decrease morbidity and futile locoregional treatments.

Methods: We performed a retrospective analysis of patients who underwent hepatectomy for colorectal liver metastases at a single center from 2000 to 2012.

Results: To identify factors associated with 5- and 10-year overall (OS) and disease-free survival (DFS), we analyzed 280 patients and 150 patients in the 5- and 10-year cohorts, respectively. Only seven relapses occurred after 5 years of follow-up, and no relapses occurred after 10 years. Multivariable analysis indicated that bilobar disease and extra-hepatic disease before hepatectomy were independent 5- and 10-year predictors of OS, and major postoperative complications predicted OS in the 5-year survival cohort only. Our analysis indicated that prognostic factors associated with DFS included some confounders and was therefore inconclusive.

Conclusions: Taken together, our results suggest that the predictors of 5- and 10-year OS rates of colorectal cancer patients with hepatic metastases are similar, differing only by postoperative complications that influenced exclusively 5-year survival. Since no relapse occurred 10 years after hepatic resection, oncological remission is likely.

Keywords: colorectal neoplasms; hepatectomy; neoplasm metastases; prognosis.

MeSH terms

  • Brazil
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Colorectal Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Hepatectomy*
  • Humans
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Postoperative Complications
  • Retrospective Studies