It is very common for colorectal cancer to spread to the liver — metastasize. Sometimes liver mets are discovered at the same time as the primary tumor in the colon or rectum, synchronous liver metastasis. At other times, the liver met follows the primary tumor after a period of time, metachronous.
Surgeons in Taiwan wanted to know if whether liver mets were synchronous or metachronous made a difference in how long patients remained cancer-free after surgery to remove the liver tumors. They reviewed 155 cases of liver resection surgery done between 1995 and 2004.
They discovered that synchronous liver tumors tended to occur in younger patients, have a greater number of mets, and be located in both lobes of the liver. About 40% of patients with synchronous mets were alive 5 years after their surgery, but cancer had returned in all but 16% of them.
Risk factors for poorer cancer-free survival included:
- synchronous metastases
- advanced stage of the original colorectal tumor
- mets in both lobes of the liver
- more than three metastases
- original tumor in the colon rather than the rectum
When all risks were considered together, synchronous tumors found at an advanced stage led to the poorest disease-free survival. These patients may need closer follow-up and aggressive chemotherapy after liver surgery.
Writing in the Annals of Surgical Oncology, Ming-Shian Tsai and colleagues concluded:
The synchronous presence of primary colon cancer and liver metastasis may indicate a more disseminated disease status and is associated with a shorter disease-free survival than metachronous metastasis. These patients may need more careful monitoring and aggressive chemotherapy following curative resection.
SOURCE: Ming-Shian Tsai et.al., Annals of Surgical Oncology, Volume 14, Number 2, February 2007, pages 786-794.
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