Distant Liver Metastases as a Major Factor Influencing Survival in Patients with Colorectal Cancer

Dimitar K. Penchev 1 , Lilyana V. Vladova 1 , Miroslav Z. Zashev 1  and Radosvet P. Gornev 1
  • 1 Department of General Surgery, Faculty of Medicine, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria


Aim: To assess the effect of the factor ‘hepatic metastatic disease’ on long-term outcomes in patients with colorectal cancer.

Materials and methods: We analysed retrospectively 200 randomly selected patients. Forty-two of them were excluded from the study for different reasons so the study contingent was 158 patients over a period of 23 years. All were diagnosed and treated in the Lozenetz University Hospital, in the Department of General Surgery. 125 of the patients were diagnosed with colorectal cancer without distant metastases and 33 of the patients had liver metastases as a result of colorectal carcinoma. The statistical analysis was performed using SPSS 19 IMB, with a level of significance of P < 0.05 at which the null hypothesis is rejected. We also used descriptive analysis, Kaplan-Meier estimator, Log-Rank Test and Life-Table statistics models.

Results: The median survival for patients without metastases was 160 months, and the median was 102 months. The median survival for patients with liver metastases was 28 months and the median was 21 months. One-year survival for patients without metastases was 92% versus 69% in patients with liver metastases. Conclusion: Average, annual and median survivals are influenced statistically significantly by the presence of liver metastases compared to overall survival and that of patients without metastatic colorectal cancer. Liver metastatic disease is a proven factor affecting long-term prognosis and survival in patients with colorectal cancer.

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