Liver resection for colorectal metastases: results and prognostic factors with 10-year follow-up

Actual 5-year survival rates after resection of colorectal liver metastases (CLM) are 25-45 %, whereas 10-year survival rates are extrapolated from survival curves. Few studies have reported long-term survivors with 10 years of actual follow-up. Therefore, no recurrences occurring after 10-plus years have been reported. The aim of our study was to analyze actual 10-year survival rates and prognostic factors. Clinical data of patients with CLM who had undergone first liver resection in our center between January 1990 and December 2000 were retrospectively analyzed. Eighty-nine patients of mean age 64 years were studied. Three patients were excluded from the study: one because of postoperative death, and two from being lost to follow-up. All other subjects had a potential 10-year follow-up. Only 33 % patients received perioperative chemotherapy. The actual 10-year overall and disease-free survival rate were 22 and 19 %, respectively. Poor prognostic factors were disease-free interval less than 1 year, wedge liver resection, clinical risk score > 2, segment 1 CLM location, and peritumoral lymphangitis. Good prognostic factors were tumors having mucinous components in primary tumor and CLM located in the right lobe. With actual long-term follow-up for 10 years, disease-free survival rate is 19 % and mainly depends on surgical management. Recurrence continues to occur more than 5 years after liver resection for CLM; cure cannot be assumed at this time. Clinical risk score is a good predictor of cure and should be taken into account when choosing perioperative treatment.