Outcome after curative resection for colorectal cancer liver metastasis in Sri Lanka

Abstract

Introduction: Colorectal cancer is the third most common cancer globally and in Sri Lanka. The liver is the commonest site of metastasis, developing in 25%-30%. Surgical resection and ablation are the only curative options available.Objective: To determine the clinical characteristics and treatment outcome in patients with colorectal cancer liver metastases.Method: Details of 73 patients with colorectal cancer liver metastases referred between 2010 and 2022 were reviewed. Demographic data, presentation, management of primary cancer and liver metastases, surgical outcome, recurrence free survival and overall survival were analyzed retrospectively.Results: The median age was 60 years (31-82) with a female predominance (n=39; 53.4%). Primary located in the left colon in 90.4% (n=66), presenting synchronously in 61.6% (n=45). Right hemi-liver (n=60; 82.2%) is more commonly involved with the caudate lobe alone involved in 1.4% (n=1). Segment VI is the commonest liver segment involved (n=39; 53.4%). Liver resection was performed in 45 patients (61.6%). 25 (55.6%) were major resections, and 6 (13.3%) were staged resections. The surgery group had a median recurrence-free survival of 24 (range=9.19-38.8) months and overall survival of 31 (range=14.51-47.50) months. 28 Patients who were offered palliative treatment had a poor overall survival of 16 (range=12.23-19.77) months (p <0.05).Conclusion: Surgical resection was possible in 61.6% of patients giving superior survival outcomes.