A team from Baltimore, Maryland, USA, examined the trends in long-term survival following liver resection for hepatic colorectal metastases.
A total of 226 consecutive patients, who underwent potentially curative resection at a single tertiary care referral center over a 16-year period (1984-1999), were included in the study.
Actuarial survival rates related to prognostic determinants were analyzed.
The median survival for the entire cohort was 46 months, with 5- and 10-year survival rates of 40% and 26%, respectively.
Of the patients, 93 were operated on between 1984 and 1992. They were found to have an overall survival of 31% at 5 years.
This compared to 58% for the 133 patients operated on during the more recent period (1993-1999).
|5-year survival rates:|
| Annals of Surgery |
Both overall and disease-free survival rates were significantly better in the recent time period, compared with the earlier period. This was true on both univariate and multivariate analyses.
Other independent factors associated with improved survival included number of metastatic tumors ≤3, negative resection margin, and CEA < 100.
The authors also made comparisons between the time periods for a variety of patient, tumor, and treatment-related factors.
Among all parameters studied, only resection type (anatomical versus non-anatomical), use of intraoperative ultrasonography, and perioperative chemotherapy administration were found to differ between the early and recent time periods.
Dr Michael A. Choti, of the Department of Surgery at Johns Hopkins Hospital, Baltimore, said on behalf of his colleagues, "Long-term survival following liver resection for colorectal metastases has improved significantly in recent years at our institution."
"Although the reasons for this survival trend are not clear, contributing factors may include the use of newer preoperative and intraoperative imaging, increased use of chemotherapy, and salvage surgical therapy," he concluded.