Approximately one in five patients with colorectal cancer (CRC) have distant metastatic disease at the time of presentation. The distant metastases, such as to the liver or lung, are the major cause of death.
We intended to determine the role of curative resection in synchronous metastatic CRC and evaluate which patients would benefit from concurrent curative resection for both primary and metastatic lesions.
Between 1983 and 2010, a total of 103 patients diagnosed with synchronous liver and/or lung metastatic CRC at Osaka Medical Center for Cancer and Cardiovascular Diseases were retrospectively studied.
All patients underwent curative resection for both primary and metastatic lesions. Median follow up time was 5.69 years. Of the 103 patients, 83 or 13 patients had only synchronous liver or lung metastasis, respectively. Seven patients had both liver and lung metastases synchronously. Twenty-five patients (24.2%) had no recurrence after curative resection. Fourteen patients (13.5%) received more than once re-resections for the recurrences and survived without any recurrences. Five-year survivals of synchronous liver or lung metastatic CRC was 43.7% or 90.0%. However, median overall survival (OS) of synchronous both liver and lung metastases was 20.7 months. In univariate and multivariate analyses, tumour invasion, synchronous liver and lung metastases, and recurrence interval after first curative resection were significantly related to OS and disease-free survival.
Curative resection confers a longer-term survival outcome in synchronous liver or lung metastatic CRC patients.