[Survival of patients with liver metastasis from colorectal cancer by different modes of therapy: a report of 363 cases].
OBJECTIVE
To evaluate the correlation between different therapies and survival of liver metastasis from colorectal cancer ( LMCC) , and to compare the clinical outcome of synchronous liver metastasis (SLM) with that of metachronous liver metastasis (MLM).


METHODS
The clinical data of 363 patients with LMCC were retrospectively reviewed with focus on the correlation between different therapy and survival.


RESULTS
Of these 363 patients, 160 had SLM and 203 had MLM. Between the SLM and MLM group, there was no significant difference in age, or gender or primary cancer site (P > 0. 05 ), but significant differences were observed in condition of liver metastasis including liver lobe involved, focus number, maximum focus diameters and level of serum CEA and CA199 before therapy(P <0. 05). Ninety-one patients underwent curative hepatic resection, 22 of them in the SLM group and 69 in the MLM group. Mortality rate related to operation was 4. 5% (1/22) in SLM group and 2. 9% (2/69) in MLM group( P < 0.05). All patients were followed until 31/6/2005. The 3-year survival rate was 5. 2% with a median survival time of 10 +/- 1 months for the SLM group, and it wasl6. 4% and 17 +/- 1 months for the MLM group (P<0.01). Regarding to the treatment modalities, the 3-year survival rate was 30. 2% with a median survival time of 26 months for curative hepatic resection group, and it was 0% - 16. 7% and 10 - 17 months for non-operation groups treated by intervention, chemotherapy, radiofrequency therapy, percutaneous ethanol injection and Chinese traditional drugs (P <0. 05, P <0. 01 ).


CONCLUSIONS
Curative hepatic resection is still the first choice for liver metastasis from colorectal cancer improving the survival significantly. Other non-operative methods also can improve phase II resection rate. Metachronous liver metastasis has higher resection rate and better survival than the synchronous liver one.
Xu
Jian-min
JM
Department of General Surgery, Zhongshan Hospital, China. xujmin@yahoo.com.cn
Qin
Xin-yu
XY
Zhong
Yun-shi
YS
Wei
Ye
Y
Fan
Jia
J
Zhou
Jian
J
Qin
Lun-xiu
LX
Wang
Jian-hua
JH
Yan
Zhi-ping
ZP
Cheng
Jie-min
JM
Wu
Zhao-han
ZH
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D016461:Chemoembolization, Therapeutic; D003110:Colonic Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D008517:Phytotherapy / Q000379:methods; D012004:Rectal Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016019:Survival Analysis
D000972:Antineoplastic Agents, Phytogenic; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen