Aggressive Multimodal Treatment and Metastatic Colorectal Cancer Survival

Background We aimed to assess patient and demographic factors, treatment trends, and survival outcomes of colorectal cancer (CRC) patients with metastasis to the liver, lung, or both sites. Conflict exists amongst national guidelines regarding the optimal management strategy. Methods Adults from the National Cancer Database (2010-2015) with a primary diagnosis of colorectal liver, lung, or liver and lung metastases were included and stratified by metastasis site. The primary outcome was 5-year overall survival, analyzed using Kaplan-Meier survival curves, log-rank test, and the Cox proportional hazards model. Results mong 82,609 included patients, 70.42% had liver, 8.74% lung, and 20.85% simultaneous liver and lung metastases (SLLM). Chemotherapy alone treatment was the most utilized (21.11%), followed by chemotherapy with colorectal radical resection (CRRR) (19.4%), no treatment (14.35%), CRRR alone (9.03%), and chemotherapy with CRRR and liver/lung resection (L/LR) (8.22%). Patients with lung metastasis had significantly better 5-year OS (p Conclusions Patients with metastasis to lung had increased overall survival compared to other sites of metastases, regardless of treatment modality. Combined resection of primary tumor, metastasectomy, and chemotherapy appears to offer the greatest chance of survival.