A preliminary analysis of combined liver resection with new chemotherapy for synchronous and metachronous colorectal liver metastasis.
OBJECTIVE
To compare the survival between patients with synchronous and metachronous colorectal liver metastases after hepatectomy with new generation of peri-operative chemotherapy.


METHODS
From October 2002 to January 2008, patients receiving hepatectomy for synchronous or metachronous colorectal liver metastasis were studied retrospectively.


RESULTS
Fifty-five patients (synchronous group=35, metachronous group=20) underwent hepatectomy for colorectal liver metastases. Besides younger age with male predominance, patients in the synchronous group had more tumour multinodularity and bilobe liver involvement. They had received less hepatic curative hepatectomy (81.1% vs. 100%) with a higher rate of peri-operative chemotherapy (91.4% vs. 50%) and postoperative morbidity (25.7% vs. 0%). However both groups had no statistical significant difference in median overall survival (OS) and disease free survival (DFS). Inferior OS and DFS were observed in the synchronous group for patients who had no peri-operative chemotherapy or those showing poor response to chemotherapy. The most favourable OS is observed in both groups after performing globally curative hepatectomy.


CONCLUSIONS
Synchronous colorectal liver metastasis is not a poor prognostic factor for survival when compared with the metachronous metastasis. Globally curative hepatectomy in combination of new generation of chemotherapy is recommended for the management of resectable colorectal liver metastasis.
Ng
Wilson Wing Chi
WW
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong SAR.
Cheung
Yue Sun
YS
Wong
John
J
Lee
Kit Fai
KF
Lai
Paul Bo San
PB
D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000628:therapy*; D011379:Prognosis