Treatment outcomes in colorectal cancer patients with synchronous liver metastases

The purpose of the study was to analyze the 2-year survival rates in colorectal cancer (CRC) patients with synchronous liver metastases after combined modality treatment including perioperative chemotherapy.

Material and Methods. A pilot prospective study included 30 colorectal cancer patients with initially resectable liver metastases, who received combined modality treatment including 3 courses of neoadjuvant chemotherapy with FOLFOXIRI in combination with cetuximab or bevacizumab (depending on the mutational status of the RAS family genes), radical surgery and 3 courses of adjuvant chemotherapy with FOLFOXIRI. The 2-year survival rates in colorectal cancer with synchronous liver metastases were analyzed on the basis of the main clinical and morphological characteristics of the tumor.

Results. Within 2-years of follow-up, disease progression occurred in 7 (23.3 %) patients, including liver metastases in 4 (13.3 %) and multiple lung metastases in 3 (10 %) patients. There were no relapses in the area of intestinal and liver resection. One patient (3.3 %) died from disease progression. The 2-year recurrence-free and overall survival rates were 76.7 % and 96.7 %, respectively. The survival rate was significantly lower in patients with урТ4 primary tumor than in patients with урT3 tumor (44.4 % and 88.2 %, respectively, p=0.015). In patients without lymph node metastases ypN0, the survival rate was 100 %, and in patients with ypN2, the survival rate decreased to 50 % (p=0.016). The survival rate reached 94.1 % in patients with 1–3 liver metastases, and it was 50 % in patients with 7–11 metastases (p=0.02).

Conclusion. Perioperative chemotherapy in CRC patients with initially resectable synchronous liver metastases provides encouraging 2-year survival rates, which are directly dependent on the extent of the tumor.

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