Our resection results in liver and lung metastases due to colorectal cancers

Colorectal cancer is the third most common cancer type in the world. Approximately 50%-60% of patients would have developed ?synchronous or metachronous- distant metastasis. The most frequent metastatic site is liver. Surgical resection of hepatic and/or pulmonary metastases of colorectal cancer have significantly prolonged in disease-free and overall survival and therefore it?s widely to be put into practice in last years.Seventy patients who underwent metastasectomy for liver and/or lung metastases due to colorectal cancer and to be treated in Dokuz Eylül University Faculty of Medicine Hospital were evaluated in this study. Demographic, perioperative, laboratory, radiological and chemotherapy as well as survival data were obtained by retrospective chart review.Thirty-nine (56%) patients had synchronous metastasis, while 31 (44%) patients had metachronous metastasis. In 44 (63%) patients liver metastases were unresectable at initial evaluation, remaining 26 (37%) patients had resectable liver metastases at this time. Simultaneous hepatic resection was applied to 15 (38%) patients with synchronous metastasis, while 22 (32%) patients underwent hepatic resection after neoadjuvant chemotherapy.Median survival time from the diagnosis of primary colorectal cancer to metachronous liver metastasis was 60 months. In patients who had metachronous metastases, the most common metastatic site was liver in 28 (90%) patients, while both liver and lung in 2 (6.5%) patients and lung in 1 (3.5%) patients respectively. While 20 (65%) of thirty patients with metachronous metastasis underwent hepatic resection, remaining 11 (35%) patients were performed hepatic resection following neoadjuvant chemotherapy.The most frequent chemotherapy regimens used as neoadjuvant therapy were De Gramont+Irinotecan (FOLFIRI) and 5-FU/Leucovorin+Oxaliplatin (FOLFOX-7) regimens. Hepatectomy and segmentectomy were the most common surgical methods in 23 (33%) and 22 (31%) patients respectively. R0 resection was obtained in 57 (80%) patients, while R1 and R2 resections were performed in 10 (14%) and 3 (6%) patients respectively. Second hepatectomy was performed in 12 (17%) patients. No perioperative mortality was seen.Adjuvant chemotherapy was given to 58 (80%) patients after metastasectomy. The most frequent chemotherapy regimens used as adjuvant treatment were FOLFIRI, FOLFOX and FOLFIRI+Bevacizumab regimens.Median follow-up period after metastatectomy in whole group was 38.6 month. While the median disease-free and overall survivals after initial metastasectomy were 12 and 28 months, respectively, the 1-year, 3-year and 5-year disease-free and overall survivals rates were 59%, 23% and 20%, and 94%, 65% and 39%, respectively. The patients who had developed recurrences before six months demonstrated poor survival rates.Both disease-free and overall survival rates were better in patients who had metachronous metastases, performed R0 resection and no recurrences, while the effect of adjuvant chemotherapy on survival was not significant.Our results comparable with the results reported in the literature in which surgical resection of liver and lung metastases due to colorectal cancer improves overall survival. Particularly, it is important to obtain R0 resection and response to neoadjuvant chemotherapy.