Hepatic Metastases of Colorectal Cancer: Therapeutic Strategy

Khazri S, Bouregba N, Khazri Z and Lamara A

Published on: 2024-07-23

Abstract

Background: Colorectal cancer ranks third among cancers worldwide, with 940,000 new cases annually; half of these patients develop liver metastases, with 20% diagnosed at the time of initial diagnosis. The treatment of colorectal liver metastases has significantly advanced in the past two decades due to advancements in various therapeutic modalities. While surgical treatment remains the only curative option, strategies have become multidisciplinary and more aggressive, leading to improved survival outcomes for patients previously facing a dismal prognosis.

Objectives: The aim of our study is to establish a protocol for the management of colorectal liver metastases and to assess the outcomes of various chemotherapy regimens used.

Methods: This prospective, descriptive, bicentric study involved 159 patients with colorectal liver metastases treated from January 2011 to January 2015 at two centers (Military Hospital of Constantine, CHB Paul Brousse). Patients with extrahepatic metastases were excluded from the study.

Results: Among the 159 patients with colorectal liver metastases, a male predominance was noted, with an average age of 62 years. Left-colonial primary localization was the most frequent. Of these, 110 patients had synchronous metastases, and 47 had metachronous ones. Approximately 80% of patients underwent perioperative chemotherapy, and 139 patients underwent resection, with a recurrence rate of 41.72%. The overall survival rate at 3 years was 54.66%.

Discussion: The treatment of colorectal liver metastases depends on several factors related to the primary cancer and hepatic disease. It often involves a combination of minor and major hepatectomies along with aggressive chemotherapy regimens.

Conclusion: The management of colorectal liver metastases is multidisciplinary and involves various therapeutic modalities. Surgical treatment remains the cornerstone, aiming to achieve better long-term survival outcomes.