Unresectable colorectal cancer liver metastases: retrospective review and survival analysis

Introduction: Colorectal cancer is the most common tumor and it is the second cause of dead by cancer in Spain. About 50% of patients develop liver metastases. The majority of patients have metastatic disease that is not suitable for curative resection.Methods: It is a retrospective review of 126 patients with unresectable colorectal liver metastases (CRLM). These patients were treated in a single institution between 2004 and 2011. Univariable and multivariable analysis were performed to identify factors associated with survival.Results: The mean overall survival was 8 months and 5-year overall survival was less than 10%. Three parameters were associated with poor survival: (1) ECOG 3 (HR 2.72, 95 % confidence interval [CI] 1.682-4.419); (2) multiple CRLM (HR 1.063, 95 % CI 1.025-1.102) and (3) Synchronous CRLM (HR 1,987, 95 % CI 1.209-3.266). One parameter was associated with better survival: treatment with chemotherapy (HR 0.56, 95 % CI 0.372-0.802).Conclusion: Although recent advances in surgery and chemotherapy have increasingly enabled liver surgery in patients with initially unresectable CRLM, not all such patients benefit from surgery. The prognostic of these patients is poor. In this setting, palliative CT should be considered. Introduction: Colorectal cancer is the most common tumor and it is the second cause of dead by cancer in Spain. About 50% of patients develop liver metastases. The majority of patients have metastatic disease that is not suitable for curative resection. Methods: It is a retrospective review of 126 patients with unresectable colorectal liver metastases (CRLM). These patients were treated in a single institution between 2004 and 2011. Univariable and multivariable analysis were performed to identify factors associated with survival. Results: The mean overall survival was 8 months and 5-year overall survival was less than 10%. Three parameters were associated with poor survival: (1) ECOG 3 (HR 2.72, 95 % confidence interval [CI] 1.682-4.419); (2) multiple CRLM (HR 1.063, 95 % CI 1.025-1.102) and (3) Synchronous CRLM (HR 1,987, 95 % CI 1.209-3.266). One parameter was associated with better survival: treatment with chemotherapy (HR 0.56, 95 % CI 0.372-0.802). Conclusion: Although recent advances in surgery and chemotherapy have increasingly enabled liver surgery in patients with initially unresectable CRLM, not all such patients benefit from surgery. The prognostic of these patients is poor. In this setting, palliative CT should be considered.