Prognostic factors after palliative resection for colorectal cancer with incurable synchronous liver metastasis

Kiichi Sugimoto, Kazuhiro Sakamoto, Yuichi Tomiki, Michitoshi Goto, Yutaka Kojima, Hiromitsu Komiyama, Makoto Takahashi, Yukihiro Yaginuma, Shun Ishiyama, Koichiro Niwa, Kiichi Nagayasu, Shingo Ito, Masaya Kawai, Kazuhiro Takehara, Yoshihiko Tashiro, Shinya Munakata

Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.

DOI: 10.4236/ojgas.2013.35044                

Abstract

Purpose: With the improvements in newer chemotherapeutic agents, there is currently no consensus regarding the validity of palliative resection of the primary tumor for colorectal cancer with incurable distant metastasis. We retrospectively analyzed prognostic factor in patients with colorectal cancer accompanied by incurable synchronous liver metastasis. Methods: 82 patients with incurable synchronous liver metastases, who underwent primary tumor resection alone, were enrolled. Results: The multivariate analysis revealed that the presence of ascites (P = 0.001, Hazard ratio = 2.96) and differentiation (P = 0.003, Hazard ratio = 3.68) were found to be significant independent prognostic factors. The median survival time among the patients with ascites was 4.8 months and that among the patients with poorly-differentiated or mucinous adenocarcinoma, or signet ring cell carcinoma (high grade differentiation) was 1.4 months, respectively. Conclusion: The presence of ascites and differentiation were prognostic factors in the patients with incurable liver metastases. Therefore, because prognosis is generally poor after primary tumor resection in the patients with ascites or high grade differentiation, the introduction of systemic chemotherapy with alleviation of symptoms related to the primary tumor should be taken into account as one of the therapeutic strategies.

Keywords

Colorectal Carcinoma; Liver Metastasis; Primary Tumor Resection; Palliative Resection; Systemic Chemotherapy; Postoperative Morbidity

Conflicts of Interest

The authors declare no conflicts of interest.

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