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


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


METHODS
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.


CONCLUSIONS
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.
Al-Sahaf
O
O
Department of General Surgery, Our Lady of Lourdes Hospital, Drogheda, Co., Louth, Ireland. Usama_sahaf70@hotmail.com
Al-Azawi
Dhafir
D
Al-Khudairy
Ammar
A
Fauzi
Mohammad Z
MZ
El-Masry
Sherif
S
Gilen
Peter
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies