Outcome of patients with colorectal liver metastasis: analysis of 1,613 consecutive cases.
Level 3 - non-randomized controlled study
Retrospective non-randomized cohort study evaluating treatment outcomes and prognostic factors
PubMed 22526903 · doi:10.1245/s10434-012-2356-9
What was done
This retrospective cohort study analyzed 1,613 consecutive patients with colorectal liver metastases (CRLM) treated between 2000 and 2010. Researchers collected clinicopathological variables and evaluated overall survival across different treatment modalities using univariate and multivariate analyses to determine independent prognostic factors.
What was found
Patients who underwent surgical resection of liver metastases achieved a median survival of 49.8 months and a 5-year survival rate of 47%, superior to other therapy modalities; untreated patients experienced the poorest survival. In 64 patients with initially unresectable disease who converted to surgical candidacy following therapy, median survival was 36.9 months and 5-year survival was 30%. Multivariate analysis identified five independent predictors of poor survival: synchronous liver metastasis, poorly differentiated primary tumor, number of liver metastases >= 4, largest metastasis >= 5 cm, and absence of surgical resection.
Why it matters
This study provides large-scale benchmark survival figures for CRLM treatments, confirming the survival advantage of liver resection—including after conversion therapy—and highlighting five key variables for clinical risk stratification.
Limits
The study is retrospective and non-randomized, introducing substantial selection bias regarding which patients were offered resection versus non-surgical therapy. Specific numeric survival outcomes, confidence intervals, and hazard ratios for the non-resected comparator groups are omitted from the abstract.
Cited by
- contradicts Patients with stage III colon cancer treated with surgical resection and the 3-drug FOLFOX chemotherapy regimen have a 65% 5-year survival rate, whereas stage IV colon cancer patients with visible liver metastases have a 0% 5-year survival rate after the same chemotherapy.