Referral patterns of patients with liver metastases due to colorectal cancer for resection

Int J Colorectal Dis. 2009 Jan;24(1):79-82. doi: 10.1007/s00384-008-0561-6. Epub 2008 Aug 12.

Abstract

Introduction: Colorectal carcinoma accounts for 10% of cancer deaths in the Western World, with the liver being the most common site of distant metastases. Resection of liver metastases is the treatment of choice, with a 5-year survival rate of 35%. However, only 5-10% of patients are suitable for resection at presentation.

Aims: To examine the referral pattern of patients with liver metastases to a specialist hepatic unit for resection.

Methodology: Retrospective review of patient's charts diagnosed with colorectal liver metastases over a 10-year period.

Results: One hundred nine (38 women, 71 men) patients with liver metastases were included, mean age 61 years; 79 and 30 patients had synchronous and metachronus metastases, respectively. Ten criteria for referral were identified; the referral rate was 8.25%, with a resection rate of 0.9%. Forty two percent of the patients had palliative chemotherapy; 42% had symptomatic treatment.

Conclusion: This study highlights the advanced stage of colorectal cancer at presentation; in light of modern evidence-based, centre-oriented therapy of liver metastasis, we conclude that criteria of referral for resection should be based on the availability of treatment modalities.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / pathology*
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Palliative Care / statistics & numerical data
  • Prognosis
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies