A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer

Background: The aim of this population-based study was to evaluate the incidence, management and prognosis of patients with hepatic metastases related to colorectal cancer using data from the Digestive Cancer Registry of Calvados, France. Methods: Of 1325 patients with colorectal cancer registered between January 1994 and December 1999, 358 developed hepatic metastases. Logistic regression was used to analyse prognostic factors. Survival analysis was carried out with Cox's proportional hazards model. Results: Some 18.8 per cent of patients had synchronous metastases, while 29.3 per cent developed metastases at 3 years. Of patients with hepatic metastases, 17.3 per cent had a surgical resection, 40.2 per cent were treated with palliative chemotherapy and 42.5 per cent had symptomatic treatment. Factors associated with receiving symptomatic treatment only -.vere age over 75 years and more than one metastasis, but not place of treatment. Median survival after a diagnosis of hepatic metastases was 10-7 (range 4.6-23. 1) months. Significant adverse prognostic factors were: age over 75 years (P = 0.001), lymph node invasion of primary turnout (P = 0.024), bilateral distribution of metastases (P = 0-001), other metastases (P = 0.004) and symptomatic treatment only (P = 0.041). Conclusion: Despite improvement in treatment for hepatic metastases, age and extent of disease remain limiting factors for surgical resection and palliative chemotherapy.