Analysis of Prognostic Factors for Resected Synchronous and Metachronous Liver Metastases from Colorectal Cancer
Table 4
Univariate analysis of factors associated with disease-free and overall survival.
DFS
OS
1 y (%)
3 y (%)
5 y (%)
Median (months, CI)
value
1 y (%)
3 y (%)
5 y (%)
Median (months, CI)
value
Timing of metastases presentation/treatment
<0.0001
0.085
Synchronous combined
25
52
24
20
14.4 (7.2–27.8)
92
66
48
45.3 (31–NE)
Synchronous “bowel first”
14
16
0
0
6 (2–11.4)
84
45
22
23.6 (11.8–70.9)
Metachronous
31
83
19
19
23.5 (14–28.8)
100
78
67
65.7 (58.2–77.2)
Age
0.648
0.552
<65
21
57
14
14
15.2 (7.2–22.1)
100
69
69
67.5 (23.6–77.9)
≥65
49
59
19
16
16.2 (10.4–23.5)
91
68
46
53 (37.9–65.7)
Sex
0.574
0.929
Male
40
59
14
11
16.4 (8.9–21.7)
95
75
57
64.2 (44.4–NE)
Female
30
58
22
22
14 (8.3–23.7)
93
58
49
38.1 (27.1–119.3)
Bowel obstruction
0.860
0.985
No
51
59
17
15
16.4 (10.4–21.7)
92
69
52
62.6 (43.7–70.9)
Yes
19
56
17
0
12.7 (4.2–28.7)
100
64
57
65.7 (21.7–119.3)
Site of primary tumor
0.488
0.661
Right colon
21
60
20
20
16.2 (8.5–29.4)
90
53
41
37.9 (17.1–77.2)
Left colon
49
58
16
13
15.2 (9.4–19.2)
96
74
60
64.7 (44.4–67.8)
CHT before liver surgery
0.080
0.531
No
37
62
23
20
19.2 (8.5–28.7)
92
71
52
62.6 (37.9–77.2)
Yes
33
54
10
10
12.7 (9.4–18)
97
63
58
62.7 (31.1–70.9)
Colorectal surgery
Technique
0.885
0.058
Open and converted
39
60
15
15
16.2 (8.9–24.8)
92
61
44
45.3 (31.3–67.1)
Minimally invasive
31
57
20
16
15.2 (8.3–23.5)
97
78
72
NE (43.7–NE)
Peritoneal resection
0.414
0.026
No
65
60
17
15
16.4 (11.8–21.7)
97
72
56
62.7 (44.3–67.8)
Yes
5
40
20
20
3.3 (1.3–NE)
60
20
20
12.4 (1.3–NE)
Liver surgery
ASA
0.003
0.036
1-2
28
73
38
33
21.5 (12.4–67.8)
92
79
62
67.8 (45.3–NE)
3
34
52
6
6
12.6 (7.2–22.4)
97
67
54
62.6 (32–67.1)
4
8
38
0
0
10.9 (1.3–19.2)
88
38
25
20.5 (1.3–NE)
Type of surgery
0.060
0.024
Minor/wedge
46
59
22
19
18 (10.4–27.8)
93
69
57
65.7 (43.7–NE)
Major
17
69
13
13
14 (6–21.5)
94
54
34
37.9 (14–62.7)
RFA
7
29
0
0
5 (1.5–18)
100
86
86
62.6 (12.4–119.3)
Surgery duration
0.999
0.945
<255 min
34
67
13
13
18 (12–25)
94
71
55
64.7 (38.1–67.8)
≥255 min
36
51
21
18
12.4 (8.5–21.7)
94
65
51
62.6 (31.1–70.9)
Complications (CD III-IV)
0.441
0.721
No
60
59
18
16
16.2 (10.4–22.1)
95
68
53
62.6 (38.1–67.5)
Yes
10
58
12
12
12.6 (1.3–30.9)
89
67
53
77.2 (9.2–77.2)
CHT after liver surgery
0.028
0.047
No
31
48
14
9
12 (5–18.1)
90
61
43
53 (19.2–70.9)
Yes
39
67
20
20
18 (11.8–27.8)
97
72
50
67.1 (44.4–70.9)
Colorectal specimen
Size
0.510
0.188
≤33 mm
26
60
8
8
18 (8.9–21.7)
100
79
57
62.7 (45.3–70.9)
34–49 mm
20
69
24
16
23.5 (7.3–29.4)
95
72
64
65.7 (32–119.3)
≥50 mm
24
48
22
22
11.8 (6–15.2)
87
51
40
37.9 (12.6–67.8)
T stage
0.002
0.347
1-2
11
51
10
10
12.4 (5–21.6)
90
68
28
53 (6–77.2)
3
56
62
19
17
16.6 (11.8–23.5)
96
68
59
64.7 (43.7–67.7)
4
3
0
0
0
3 (2–3.3)
50
50
50
40 (9.2–70.9)
Positive nodes
0.098
0.018
0
25
75
21
21
20.3 (12.4–28.8)
96
86
65
67 (53–119.3)
1–3
21
54
21
16
14.4 (5.8–28.7)
100
83
64
64.7 (37.9–70.9)
4+
24
46
10
10
10.4 (3.6–16.6)
87
37
31
21.7 (14–77.2)
Mucinous histotype
0.940
0.286
No
57
58
17
15
58.2 (38–67)
96
68
50
Yes
13
60
17
17
(9–119.3)
84
67
67
Liver specimen
Resected lesions
0.0001
0.066
1
35
73
26
22
21.6 (15.2–28.7)
91
74
56
64.7 (43.7–77.2)
2-3
20
63
16
16
14.4 (7.3–23.5)
95
60
54
62.7 (21.7–NE)
4+
8
13
0
0
5.7 (1.9–8.5)
100
43
14
27.1 (13.9–38.1)
Size
0.199
0.088
I tertile
20
55
20
15
17.2 (8.5–25)
90
73
50
60.4 (31.3–67.5)
II tertile
22
73
25
25
22.5 (12–28.8)
95
75
60
NE (32–NE)
III tertile
21
57
11
11
12.6 (5–24.8)
94
45
39
31.5 (14–70.9)
Margin status
0.032
0.859
Negative
59
63
20
18
16.5 (12–23.5)
100
66
50
58.2 (37.9–67.5)
Positive
4
38
0
0
4.8 (2–15.2)
93
50
50
47.2 (23.6–70.1)
NE = not evaluable; CHT = chemotherapy; ASA = American Society of Anesthesiologists; Minor/wedge = minor hepatectomies/hepatic wedge resections; Major = major hepatectomies; RFA = radiofreqency ablation; CD III-IV = Clavien-Dindo classification grade III-IV. T stage according to TNM definition AJCC 7th edition.
