[Prognostic analysis of 220 colorectal cancer patients with synchronous liver metastases].
OBJECTIVE
Colorectal cancer is one of the most common malignant tumors in China. Synchronous liver metastases occur in 10%-25% colorectal cancer patients. This study was to elucidate the prognostic factors and treatment choices for colorectal cancer patients with synchronous liver metastases.


METHODS
Records of 220 colorectal cancer patients with synchronous liver metastases initially treated at Cancer Center of Sun Yat-sen University from Dec. 1995 to Dec. 2002 were reviewed. Prognostic factors were analyzed by Kaplan-Meier method and Cox regression model with SPSS12.0 software.


RESULTS
The 5-year overall survival rate was 5.52%, the median survival time of the patients was 12.93 months. Univariate analysis of clinical characteristics revealed that the number, size and distribution of liver metastases, extrahepatic disease, serum CEA level at diagnosis, N status, and histology were prognostic factors. Univariate analysis of clinical treatment factors showed that treatment modality, primary site resection, and chemotherapy regimen were prognostic factors. Multivariate analysis showed that the number and size of liver metastases, extrahepatic disease, serum CEA value at diagnosis, treatment modality, primary tumor resection, and chemotherapy regimen were independent prognostic factors of colorectal cancer patients with synchronous liver metastases.


CONCLUSIONS
Liver metastases larger than 5 cm in diameter, bilobar liver metastases, extrahepatic invasion or metastases, and CEA level more than 200 microg/L at diagnosis are adverse prognostic factors. Primary tumor resection and liver resection should be considered for all suitable patients with colorectal metastases to the liver alone. Liver-target intervention and/or systemic chemotherapy might be a good choice for inoperable patients. If possible, systemic chemotherapy containing oxaliplatin is preferred.
He
Yi-Fu
YF
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060 P. R. China.
Li
Yu-Hong
YH
Zhang
Dong-Sheng
DS
Xiang
Xiao-Juan
XJ
Xu
Rui-Hua
RH
Pan
Zhi-Zhong
ZZ
Zhou
Zhi-Wei
ZW
Jiang
Wen-Qi
WQ
He
You-Jian
YJ
Wan
De-Sen
DS
D000230:Adenocarcinoma / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate