Factors that predict survival in patients with colorectal cancer who made liver metastazectomy

Introduction: Colorectal cancer is the most common malign tumour of gastrointestinal system. Liver metastases are seen in a significant part of the patients during the course of the disease. Liver metastasectomy is an important treatment option that reduces the risk of disease recurrence and death. However, not all patients benefit from metastasectomy at the same rate. Therefore, it is important to determine predictive values that will predict survival after metastasectomy. Objective: In this study, it was aimed to determine the predictive values in patients with CRC who underwent liver metastasectomy and to determine the relationship between predictive values and survival time after metastasectomy. Method: 57 patients with CRC who applied to Akdeniz University Hospital Medical Oncology Clinic and underwent liver metastasectomy were included in the study. Demographic characteristics, oncological histories, and potential predictive values of patients were obtained retrospectively from patient files and hospital information management system. Firstly, the overall survival (OS) and progression-free survival (PFS) times of the patients after metastasectomy were calculated with the obtained data. The relationship between predictive values and OS and PFS was then analyzed. Results: 57 patients with sufficient data for analysis were included in the study. 70.2% of the patients were male and the mean age was 59.5±11.1 years. The primary diagnosis site of 40 patients (70.2%) was the left colon. 37 patients (59.6%) were metastatic to the liver at the time of diagnosis. Recurrence developed in 39 patients (68.4%) and 22 patients (38.6%) died. The median total follow-up period of the patients was 41 (IQR: 25-71) months. In the evaluation, the median overall survival time was 66 months (95%GA: 42.259-89.741), and the median progression-free survival was 15 months (95%GA: 10.162-19.838). Conclusion: In our study, stage 4 disease, LMR ≤ 2.51, CEA>; 23.25, CRP>1.4 were found to be associated with shortened OS times (p=0.021; p=0.004; p=0.002; p=0.024). Right colon localized tumor and stage 4 disease were associated with shortened PFS times (p=0.023; p=0.002). In the univariate Cox regression analysis, although a statistically significant relationship was found for right colon localization and stage 4 disease with PFS, it was not found significant in the multivariate analysis. In addition, in the univariate analysis performed for OS, stage 4 disease, LMR ≤ 2.51, CEA> 23.25, CRP>;1.4 were found to be statistically significant, but in the multivariate analysis, only CEA>23.25 was found to be a independet risk factor. Key Words: Colorektal cancer, liver metastasis, liver metastasectomy, survival, predictive factors