Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases – A ten year study

BackgroundCurrently liver resection offers the only potential cure for colorectal liver metastases (CRLM). We prospectively audited the outcome of CRLM treated by a combination of neo-adjuvant chemotherapy and surgery.Methods283 consecutive patients underwent liver resection for CRLM over 10 years with curative intent. Patients received chemotherapy preoperatively for synchronous and early (<2 years) metachronous metastases. Univariate and multivariate analyses were used to identify mortality risk factors.ResultsOverall survival at 1, 3 and 5 years was 90%, 59.2% and 46.1%, respectively. Disease free survival at 1, 3 and 5 years was 68.1%, 34.8% and 27.9%, respectively. Operative mortality was 2.1% and morbidity was 23.7%. Patients with macroscopic diaphragm invasion by tumour, CEA >100 ng/ml, tumour size >5 cm or cancer involved resection margins (CIRM) had a significantly worse overall survival. Incidence of CIRM and re-resection was 4.9% and 4.5%, respectively.ConclusionsNeo-adjuvant chemotherapy followed by liver surgery is associated with improved survival and low CIRM and re-resection rates.