Article
Outcome of patients with colorectal cancer and synchronous metastases (UICC IV)
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Published: | March 20, 2006 |
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Background: In the last years there have been significant changes in the strategy for treatment of colorectal liver metastases. In this retrospective analysis we report the outcome of patients with synchronous colorectal liver metastases ± extra hepatic disease at primary presentation and diagnosis. We compared patients who were treated with chemotherapy only to patients with liver resection and/or local ablative techniques in combination with chemotherapy.
Methods: A total of 31 patients were reviewed from August 2002 until October 2005 after treatment with chemotherapy in the department of Surgical Oncology.
Results: Patient characteristics: The median age was 61 years (range 35 – 73) and 71% of patients were male. 61% of patients presented with liver metastases only and 39% showed additionally metastatic sides. In 51% of patients a liver resection and/or a radiofrequency ablation were performed whereas 49% were treated with chemotherapy only. In 62.5% of all resected patients one liver resection was performed and in 37.5% we were able to re-resect the patient. The median amount of chemotherapy was 3 regimens (range 1 – 7). In two patients the primary was not resected. (Table 1 [Tab. 1])
Conclusion: Our patients demonstrate favourable results superior to most data presented in other reports. Unfortunately only in a few series synchronous and metachronous tumours were differentiated though scoring systems have shown that synchronous presentation of metastases with the primary tumour adversely affects survival. From our experience primary tumour resection and liver resection ± local ablative techniques should always be considered in this high-risk population.