Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-006-9215-5
Annals of Surgical Oncology 14:786-794 (2007)
© 2007 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tsai, M.-S.
Right arrow Articles by Lee, P.-H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tsai, M.-S.
Right arrow Articles by Lee, P.-H.

Original Article

Clinicopathological Features and Prognosis in Resectable Synchronous and Metachronous Colorectal Liver Metastasis

Ming-Shian Tsai, MD1,3, Yen-Hao Su, MD2, Ming-Chih Ho, MD2, Jin-Tung Liang, MD, PhD1, Tzu-Ping Chen, MS4, Hong-Shiee Lai, MD, PhD2 and Po-Huang Lee, MD, PhD2

1 Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan
2 Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
3 Institute of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan
4 Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan

Correspondence: Address correspondence and reprint requests to: Jin-Tung Liang, MD, PhD; E-mail: jintung{at}ha.mc.ntu.edu.tw

Introduction: Hepatic resection may offer long-term survival for patients with colorectal metastases. However, controversies exist regarding the prognostic factors. Herein, the impact of synchronicity of liver metastasis on patient clinicopathological features and prognosis was evaluated.

Methods: One hundred and fifty-five patients who underwent hepatectomy for colon cancer metastasis, from 1995 to 2004, were enrolled in this study. Patients were divided into two groups: synchronous and metachronous colorectal liver metastasis. Patient demographics, the nature of the primary and metastatic tumors, surgery-related complications, and long-term outcome were analyzed.

Results: Patients included in the synchronous group tended to be younger than those in the metachronous group. Compared to the metachronous group, patients in the synchronous group showed more metastases (P = 0.008) and bilobarly distributed metastases (P = 0.016). Bile leakage was the most common surgical complication. The estimated 5-year disease-free and overall survival rates were 16.8 and 41.1%, respectively. Univariate analysis indicated that synchronous metastases, advanced stage of the primary tumor, bilobar distribution of the metastases, more than three metastases, and colonic versus rectal location of the primary tumor were prognostic factors of shorter disease-free survival, but not overall survival. Multivariate analysis revealed that synchronous metastases and the advanced stage of the primary tumor were indicators for a worse disease-free survival.

Conclusion: The synchronous presence of primary colon cancer and liver metastasis may indicate a more disseminated disease status and is associated with a shorter disease-free survival than metachronous metastasis. These patients may need more careful monitoring and aggressive chemotherapy following curative resection.

Key Words: Colorectal cancer • Metastases • Liver resection • Prognosis






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the Society of Surgical Oncology.