[Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer-a multifactorial model of 191 patients].
OBJECTIVE
To identify risk factors associated with overall survival (OS) for patients undergoing primary hepatic resection for metastatic colorectal cancer.


METHODS
The clinical and pathological data were prospectively collected from 191 consecutive patients undergoing primary hepatic resection for colorectal liver metastases from January 2000 to August 2012. The survival curve was drawn by Kaplan-Meier method, and the survival rates were analyzed by Log-rank test. Parametric survival analysis was used to identify predictors of cancer-specific survival.


RESULTS
The 5-year overall survival were 38.4% and median survival time was 33 months; 5-year disease-free survival were 23.6%, and the median disease-free survival time was 10.0 months. 5-years survival rate was significantly lower in patients with synchronal metastasis than in patients with heterochronia metastasis (27.4% vs. 51.8%, χ(2) = 6.527, P < 0.05). In overall survival, univariate analysis found 7 risk factors: gender (χ(2) = 5.219), N stage of the primary tumor (χ(2) = 5.591), bilobar metastases (χ(2) = 4.269), number of metastases ≥ 2 (χ(2) = 5.051), disease-free interval ≥ 6 months (χ(2) = 6.527), carcinoembyonic antigen level ≥ 30 µg/L (χ(2) = 4.454), and extrahepatic disease (χ(2) = 5.158). On multivariate analysis, 3 risk factors were found to be independent predictors of poor survival: N stage of the primary tumor (RR = 2.198, 95%CI: 1.146-4.216), disease-free interval ≥ 6 months (RR = 1.840, 95%CI: 1.139-2.973), carcinoembyonic antigen level ≥ 30 µg/L(RR = 1.854, 95%CI: 1.056-3.255).


CONCLUSIONS
Resection of liver metastases provides good long-term cancer-specific survival benefit. N stage of the primary tumor, disease-free interval, carcinoembyonic antigen level are important prognostic factors for colorectal liver metastasis.
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Qinglong
Q
Jiang
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Xiaoluan
X
Yan
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Kun
K
Wang
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Quan
Q
Bao
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Yi
Y
Sun
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Hongwei
H
Wang
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China.
Kemin
K
Jin
Departement of Hepatopancreatobiliary, Beijing Cancer Hospital, Beijing Institute for Cancer Rearch, Peking University, Beijing 100142, China. Email: xingbaocai88@sina.com.
Baocai
B
Xing
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
D002272:Carcinoembryonic Antigen