title: Incidence and survival in late liver metastases of colorectal cancer.
abstract: OBJECTIVE
  Data concerning the risk of long-term liver metastasis following surgery of colorectal cancer in the general population are scarce. The 10-year incidence and prognosis of metachronous liver metastases remain unknown.
  
  
  METHODS
  Among 4584 patients resected for cure for colorectal cancer recorded in two French digestive population-based cancer registries between 1985 and 2000, 602 presented metastases including liver metastases.
  
  
  RESULTS
  The cumulated incidence of liver metastasis was 15% at 5 years and 17% at 10 years, and was mainly related to stage at diagnosis. The 10-year cumulative incidence was 6% for stage I and 30% for stage III. The hazard ratio was 3.2 [2.4-4.3] for stage II and 6.9 [5.1-9.2] for stage III compared with stage I. Among survivors with no recurrence five years after diagnosis, 2.2% developed liver metastasis between 5 and 10 years. Resection for cure of liver metastases was performed in 35% of patients aged under 75 years and in 10% of patients over 75 (P < 0.001). After resection for cure, 10-year relative survival improved from 21% during the period 1985-1997 to 34% during the period 1998-2011 (P = 0.023). Survival in patients with liver metastasis diagnosed between six and 12 months after surgery was less than half that in patients with metastasis diagnosed later (HR: 0.6 [0.4-1.0]).
  
  
  CONCLUSIONS
  Liver metastases from colorectal cancer remain a substantial problem and continue to occur long after five years. This study furnishes unbiased figures that can be used as a reference. Liver metastases that appear late have a better prognosis.
authors.affiliation: Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Landreau
authors.forename: Antoine
authors.initials: A
authors.lastname: Drouillard
authors.forename: Guy
authors.initials: G
authors.lastname: Launoy
authors.forename: Pablo
authors.initials: P
authors.lastname: Ortega-Deballon
authors.forename: Valérie
authors.initials: V
authors.lastname: Jooste
authors.forename: Côme
authors.initials: C
authors.lastname: Lepage
authors.forename: Jean
authors.initials: J
authors.lastname: Faivre
authors.forename: Olivier
authors.initials: O
authors.lastname: Facy
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
mesh_terms: D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D008297:Male; D009367:Neoplasm Staging; D012306:Risk; D015996:Survival Rate; D013997:Time Factors
keywords: cancer registry; colorectal cancer; incidence; long-term liver metastasis; survival