TREATMENTS OF METACHRONOUS LIVER METASTASES FROM COLORECTAL CANCER

Twenty-seven patients with colorectal cancer having metachronous liver metastasis were evaluated regarding the clinicopathological features and the treatments. Liver metastasis is likely to occur from a primary lesion in an advanced stage, with lymphnode involvement and venous permeation. Although serum CEA was elevated in 20 patients (91%), the liver secondaries were determined in only 12 patients (60%) at the time of turning positive. The metachronous liver metastasis was determined in 19 patients (70%) within 2 years after resection of the colorectal tumors. Five year-survival rate was 18% and the median survival time, 17 months in all patients with metachronous liver metastasis. Among the extents of liver metastases, the prognosis of patients with H1 was best as shown by the 5 year-survival rate of 35% and median survival time of 21 months. Among the types of treatments, the prognosis of patients undergone hepatic resection was best, showing 60% of 5 year-survival rate. As to the time of recurrence, the prognosis of patients experienced the metastases within 1 year was as poor as 8.5 months of median survival time. These results suggest that aggressive hepatic resection with early diagnosis of meta-chronous liver metastasis is most preferable.