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Epidemiology and Management of Liver Metastases From Colorectal Cancer

Manfredi, Sylvain MD; Lepage, Côme MD; Hatem, Cyril MD; Coatmeur, Olivier MD; Faivre, Jean PhD; Bouvier, Anne-Marie PhD

doi: 10.1097/01.sla.0000217629.94941.cf
Original Articles

Objective/Background: Little is known about the epidemiology and the management of liver metastases from colorectal cancer at a population level. The aim of this population-based study was to report on the incidence, treatment, and prognosis of synchronous and metachronous liver metastases.

Methods: Data were obtained from the population-based cancer registry of Burgundy (France).

Results: The proportion of patients with synchronous liver metastases was 14.5%. Age-standardized incidence rates were 7.6 per 100,000 in males, 3.7 per 100,000 in females. The 5-year cumulative metachronous liver metastasis rate was 14.5%. It was 3.7% for TNM stage I tumors, 13.3% for stage II, and 30.4% for stage III (P < 0.001). The risk of liver metastasis was also associated to gross features. Resection for cure was performed in 6.3% of synchronous liver metastases and 16.9% of metachronous liver metastases. Age, presence of another site of recurrence, and period of diagnosis were independent factors associated with the performance of a resection for cure. The 1- and 5-year survival rates were 34.8% and 3.3% for synchronous liver metastases. Their corresponding rates were, respectively, 37.6% and 6.1% for metachronous liver metastases.

Conclusion: Liver metastases from colorectal cancer remain a substantial problem. More effective treatments and mass screening represent promising approaches to decrease this problem.

The aim of this population-based study was to report on the incidence, treatment, and prognosis of synchronous and metachronous liver metastases from colorectal cancers. The age-standardized incidence rate of synchronous liver metastases was 7.6 per 100,000 in males and 3.7 per 100, 000 in females. The overall actuarial cumulative rate of metachronous liver metastasis was 4.3% at 1 year and 16.5% at 5 years. Stage at diagnosis was the most important determinant of the risk of metachronous liver metastasis. Surgical resection for cure is the only possibility to obtain long-term survival.

From Registre Bourguignon des Cancers Digestifs, Faculté de Médecine, Dijon Cedex, France.

Reprints: Anne-Marie Bouvier, PhD, Registre Bourguignon des Cancers Digestifs (INSERM EMI 106 and CIC-EC01), Faculté de Médecine, BP 87900 21079 DIJON Cedex, France. E-mail: anne-marie.bouvier@u-bourgogne.fr.

© 2006 Lippincott Williams & Wilkins, Inc.