589P - Survival analysis of 1,061 patients with synchronous colorectal hepatic metastases

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Colon Cancer
Rectal Cancer
Presenter Jianmin Xu
Authors J. Xu, Y. Zhong, D. Zhu, Y. Wei, L. Ren
  • Department Of General Surgery, Zhongshan Hospital Fudan University, 200032 - Shanghai/CN

Abstract

Objectives

To investigate survival and to identify prognostic factors in patients with synchronous colorectal hepatic metastasis.

Methods

Clinical, pathologic and follow-up data were retrospectively collected from 1,061 consecutive patients treated for synchronous colorectal hepatic metastases at Zhongshan Hospital between 2000 and 2010. The prognostic values of different factors were studied through univariate and multivariate analyses.

Results

For patients with resectable hepatic metastases, the total expense per patient in the simultaneous resection group was lower than that in the staged resection group (25,693 RMB vs. 34,129 RMB, P < 0.050), and there were no significant differences in the complication rates (24.5% vs. 20.5%) or median overall survival (48.5 vs. 47.0 months) between the simultaneous and staged resection groups. For patients with unresectable hepatic metastases, resection of the primary tumor was associated with improved median overall survival (19.0 vs. 9.3 months, P < 0.001). Six factors were found to be independent predictors of poor survival by multivariate analysis: a poorly differentiated primary tumor, number of hepatic metastases ≥ 4, maximum hepatic metastasis size ≥ 5 cm, extra-hepatic metastases, no resection of the primary tumor and no surgical treatment of hepatic metastases. Giving one point to each of the above factors, all of the patients were divided into low-risk (0-1 points), medium-risk (2-3 points) and high-risk (4-6 points) groups with 5-year survival rates of 51%, 16% and 0%, respectively (P < 0.001).

Conclusions

Simultaneous resection of the primary tumor and hepatic metastases were accepted as prognostic factors in patients with resectable synchronous colorectal hepatic metastases. Resection of the primary tumor was recommended at the right time for asymptomatic patients with unresectable hepatic metastases. A prediction model using the above six factors can be used to guide the clinical management of patients with synchronous colorectal hepatic metastases.

Disclosure

All authors have declared no conflicts of interest.