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Incidence and survival in late liver metastases of colorectal cancer
Author(s) -
Landreau Pierre,
Drouillard Antoine,
Launoy Guy,
OrtegaDeballon Pablo,
Jooste Valérie,
Lepage Côme,
Faivre Jean,
Facy Olivier,
Bouvier AnneMarie
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12685
Subject(s) - medicine , metastasis , incidence (geometry) , colorectal cancer , stage (stratigraphy) , cancer , cumulative incidence , population , hazard ratio , gastroenterology , surgery , oncology , cohort , confidence interval , biology , paleontology , physics , environmental health , optics
Background and Aims Data concerning the risk of long‐term liver metastasis following surgery of colorectal cancer in the general population are scarce. The 10‐year incidence and prognosis of metachronous liver metastases remain unknown. Methods Among 4584 patients resected for cure for colorectal cancer recorded in two French digestive population‐based cancer registries between 1985 and 2000, 602 presented metastases including liver metastases. Results The cumulated incidence of liver metastasis was 15% at 5 years and 17% at 10 years, and was mainly related to stage at diagnosis. The 10‐year cumulative incidence was 6% for stage I and 30% for stage III . The hazard ratio was 3.2 [2.4–4.3] for stage II and 6.9 [5.1–9.2] for stage III compared with stage I . Among survivors with no recurrence five years after diagnosis, 2.2% developed liver metastasis between 5 and 10 years. Resection for cure of liver metastases was performed in 35% of patients aged under 75 years and in 10% of patients over 75 ( P < 0.001). After resection for cure, 10‐year relative survival improved from 21% during the period 1985–1997 to 34% during the period 1998–2011 ( P = 0.023). Survival in patients with liver metastasis diagnosed between six and 12 months after surgery was less than half that in patients with metastasis diagnosed later ( HR : 0.6 [0.4–1.0]). Conclusion Liver metastases from colorectal cancer remain a substantial problem and continue to occur long after five years. This study furnishes unbiased figures that can be used as a reference. Liver metastases that appear late have a better prognosis.