208P - Significance of the difference in size of liver tumors in management of patients with colorectal liver metastases

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Colon and Rectal Cancer
Rectal Cancer
Surgical Oncology
Presenter Kosuke Ichida
Citation Annals of Oncology (2016) 27 (suppl_9): ix53-ix67. 10.1093/annonc/mdw581
Authors K. Ichida1, K. Suzuki2, Y. Muto1, T. Fukui1, Y. Takayama1, K. Futsuhara1, S. Tsujinaka1, Y. Miyakura1, H. Noda1, T. Rikiyama1
  • 1Surgery, Jichi Medical University Saitama Medical Center, 330-8503 - Saitama/JP
  • 2Surgery, Jichi Medical University Saitama Medical Center, Saitama/JP



The combination of chemotherapy and surgery is currently accepted for the treatment of patients with technically resectable colorectal liver metastases. It is, however, hard to determine which way of chemotherapy or surgery should forward. In this study, we assessed the significance of the difference in size of tumors in pre-therapeutic imaging on the selection of chemotherapy in these patients.


We present a retrospective review of 80 consecutive colorectal liver metastases without extrahepatic tumors. The relapse free survival (RFS), the progression free survival (PFS) and overall survival (OS) were assessed and compared between patients with surgery (n = 66) and chemotherapy (n = 14) according to clinical features. Especially, we addressed on pre-therapeutic imaging studies including the distribution and the number of metastatic liver tumors. In addition, the ratio of size in largest to smallest tumor was calculated, two groups classified R 


Univariate analysis was performed in the surgery group, which revealed that that significant difference in RFS was seen in time of occurrence, the number of tumors and the ratio of tumor diameters. Multivariate analysis showed that the ratio of tumor size, R ≥ 5 was the only independent prognostic risk factor in both RFS and OS. We then compared the outcome of patients with prognostic risk factors between surgery and chemotherapy. Surgery gave significantly better OS in those patients than chemotherapy except those with R ≥ 5. No difference of OS, in addition to RFS and PFS, was seen in patients with R ≥ 5, regardless of treatment.


CRC patients with resectable liver metastases harboring R ≥ 5 showed no significant difference in outcome by surgery and chemotherapy. Chemotherapy could be an alternative to forward surgery to access oncological concerns such as latent metastases or poor treatment outcome for these patients.

Clinical trial indentification

Legal entity responsible for the study

Jichi Medical University


Japan Society for the Promotion of Science


All authors have declared no conflicts of interest.