Resection of liver metastases from colorectal cancer: Are there any truly significant clinical prognosticators?

PURPOSE: This study was designed to evaluate the prognostic significance of various prognostic factors affecting recurrence after resection of colorectal hepatic metastases. PATIENTS AND METHODS: Records of 54 patients who had hepatic resection between 1986 and 1993 for metastatic liver tumor from colorectal cancer were reviewed. Factors analyzed were those reported to be of prognostic significance in other studies, including gender, primary tumor site, Dukes stage, diagnostic interval, grade, preoperative carcinoembryonic antigen (CEA) level, number of metastases, size of metastases, distribution of metastases, type of resection, resection margin, and estimated blood loss. RESULTS: Average follow-up of surviving patients was 28 (range, 12-89) months. Average survival time from date of hepatic resection was 26 months, with an estimated actuarial survival rate of 25.5 percent at five years. Using the multivariate analysis of factors, gender and preoperative CEA level were shown to be significantly related to overall survival (P = 0.0455 and 0.054, respectively). Cancer of the right side colon had significant correlation with hepatic 'recurrence' (P = 0.0071). CONCLUSIONS: Female patients and those with preoperative CEA values higher than 20 ng/ml have a better chance of survival following hepatic resection. Cancer of tile right colon has a greater tendency for hepatic recurrence than that of the left colon.