Journal Article
. 1994 Jun; 343(8910):1405-10.
doi: 10.1016/s0140-6736(94)92529-1.

Factors influencing the natural history of colorectal liver metastases

R Stangl 1 A Altendorf-Hofmann  R M Charnley  J Scheele  
Affiliations
  • PMID: 7515134
  •     181 citations

Abstract

Palliative treatment of unresectable colorectal liver metastases is common and often justified with reference to historical data on the natural history of the disease. However, in view of the improved diagnostic accuracy of modern imaging techniques, these previously published series do not provide sufficient guidance to judge the prognostic efficacy of palliative treatment. In the late 1970s we started prospectively to collect data on consecutive patients with colorectal liver metastases according to a standard protocol. We now present data derived from this series on factors that may affect outcome in untreated patients. Between January, 1980, and December, 1990, 1099 consecutive patients were recorded, of whom 566 (51.5%) received no treatment for their hepatic tumour. Excluding 34 early deaths and 48 patients with a second malignant tumour, 484 patients provided the basis for analysis. All patients were followed up to July 1, 1993, or death. At the closing date of the study only 1 untreated patient was still alive. The impact of various factors on survival was analysed by univariate and multivariate analyses. Six independent determinants of survival were identified in the following order: percentage liver volume replaced by tumour (LVRT), grade of malignancy of the primary tumour, presence of extrahepatic disease, mesenteric lymph-node involvement, serum carcino-embryonic antigen, and age. The subsequent combination of the independently significant factors, separately for patients with up to or more than 25% LVRT, yielded a prognostic tree that displayed median survival times of various subgroups of 3.8 to 21.3 months. These findings provide a framework to estimate the survival expectancy of untreated patients, thereby allowing improved assessment of the prognostic significance of palliative therapeutic approaches.

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Curr Colorectal Cancer Rep, 2014 Sep 06; 10(3). PMID: 25191154    Free PMC article.
Review.
CT predictors of overall survival at initial diagnosis in patients with stage IV colorectal cancer.
Michael H Rosenthal, Kyung Won Kim, +2 authors, Nikhil H Ramaiya.
Abdom Imaging, 2014 Oct 19; 40(5). PMID: 25326260    Free PMC article.
History and present status of pulmonary metastasectomy in colorectal cancer.
Tom Treasure, Mišel Milošević, Francesca Fiorentino, Joachim Pfannschmidt.
World J Gastroenterol, 2014 Oct 31; 20(40). PMID: 25356017    Free PMC article.
Review.
"Vanishing liver metastases"-A real challenge for liver surgeons.
Alex Zendel, Eylon Lahat, +3 authors, Arie Ariche.
Hepatobiliary Surg Nutr, 2014 Nov 14; 3(5). PMID: 25392841    Free PMC article.
Review.
Strategies for Management of Synchronous Colorectal Metastases.
Jason A Castellanos, Nipun B Merchant.
Curr Surg Rep, 2014 Nov 29; 2. PMID: 25431745    Free PMC article.
Novel methods for clinical risk stratification in patients with colorectal liver metastases.
Ki-Yeol Kim, Nam Kyu Kim, +10 authors, Sang Joon Shin.
Cancer Res Treat, 2014 Dec 09; 47(2). PMID: 25483744    Free PMC article.
Selective Internal Radiation Therapy (SIRT) with yttrium-90 resin microspheres plus standard systemic chemotherapy regimen of FOLFOX versus FOLFOX alone as first-line treatment of non-resectable liver metastases from colorectal cancer: the SIRFLOX study.
Peter Gibbs, Val Gebski, +4 authors, SIRFLOX Study Group.
BMC Cancer, 2014 Dec 10; 14. PMID: 25487708    Free PMC article.
Weichang'an and 5-fluorouracil suppresses colorectal cancer in a mouse model.
Li Tao, Jin-Kun Yang, +4 authors, Ying-Jie Zhu.
World J Gastroenterol, 2015 Jan 30; 21(4). PMID: 25632185    Free PMC article.
Tumour growth of colorectal rat liver metastases is inhibited by hepatic arterial infusion of the mTOR-inhibitor temsirolimus after portal branch ligation.
Jens Sperling, Christian Ziemann, +3 authors, Otto Kollmar.
Clin Exp Metastasis, 2015 Feb 20; 32(4). PMID: 25693517
Nomogram including pretherapeutic parameters for prediction of survival after SIRT of hepatic metastases from colorectal cancer.
Wolfgang Peter Fendler, Harun Ilhan, +7 authors, Alexander R Haug.
Eur Radiol, 2015 Feb 28; 25(9). PMID: 25721320
Laparoscopic Simultaneous Resection of Colorectal Primary Tumor and Liver Metastases: Results of a Multicenter International Study.
Stefano Ferretti, Hadrien Tranchart, +13 authors, Ibrahim Dagher.
World J Surg, 2015 Mar 31; 39(8). PMID: 25813824
Cancer Treatment: The Cost Factor.
S Smith.
West Indian Med J, 2015 Apr 14; 63(7). PMID: 25867563    Free PMC article.
Proposal for novel histological findings of colorectal liver metastases with preoperative chemotherapy.
Kazuyuki Ishida, Noriyuki Uesugi, +7 authors, Tamotsu Sugai.
Pathol Int, 2015 May 06; 65(7). PMID: 25940915    Free PMC article.
Management of liver metastases from colorectal cancer.
Yu Katayose, Michiaki Unno.
Clin J Gastroenterol, 2010 Jun 01; 3(3). PMID: 26190118
Synchronous Resectable Metastatic Colorectal Cancer: Lymph Node Involvement Predicts Poor Outcome.
Jianfei Fu, Mengjie Jiang, +5 authors, Ying Yuan.
Medicine (Baltimore), 2015 Jul 30; 94(30). PMID: 26222850    Free PMC article.
Feasibility of the liver-first approach for patients with initially unresectable and not optimally resectable synchronous colorectal liver metastases.
Masayuki Okuno, Etsuro Hatano, +12 authors, Shinji Uemoto.
Surg Today, 2015 Sep 01; 46(6). PMID: 26315324
Factors affecting recurrence and prognosis after R0 resection for colorectal cancer with peritoneal metastasis.
Harunobu Sato, Koutaro Maeda, +2 authors, Hiroshi Takahashi.
J Gastroenterol, 2015 Sep 18; 51(5). PMID: 26377391
Intraoperative Contrast-Enhanced Ultrasound in Colorectal Liver Metastasis Surgery Improves the Identification and Characterization of Nodules.
Julien Hoareau, Aurélien Venara, +4 authors, Christophe Aube.
World J Surg, 2015 Oct 17; 40(1). PMID: 26470698
Colorectal cancer: Metastases to a single organ.
Sina Vatandoust, Timothy J Price, Christos S Karapetis.
World J Gastroenterol, 2015 Nov 12; 21(41). PMID: 26557001    Free PMC article.
Review.
Sciellin mediates mesenchymal-to-epithelial transition in colorectal cancer hepatic metastasis.
Chuan-Kai Chou, Chi-Chen Fan, +6 authors, Wei-Chao Chang.
Oncotarget, 2016 Mar 26; 7(18). PMID: 27013588    Free PMC article.
Time-to-Surgery and Survival Outcomes in Resectable Colorectal Liver Metastases: A Multi-Institutional Evaluation.
Julie N Leal, Alexsander K Bressan, +12 authors, William R Jarnagin.
J Am Coll Surg, 2016 Apr 27; 222(5). PMID: 27113514    Free PMC article.
Conversion Chemotherapy for Technically Unresectable Colorectal Liver Metastases: A Retrospective, STROBE-Compliant, Single-Center Study Comparing Chemotherapy Alone and Combination Chemotherapy With Cetuximab or Bevacizumab.
Michele Basso, Vincenzo Dadduzio, +9 authors, Carlo Barone.
Medicine (Baltimore), 2016 May 20; 95(20). PMID: 27196492    Free PMC article.
Radiofrequency ablation vs. hepatic resection for resectable colorectal liver metastases.
Nan He, Qian-Na Jin, +4 authors, Kai-Xiong Tao.
J Huazhong Univ Sci Technolog Med Sci, 2016 Jul 29; 36(4). PMID: 27465325
Multisciplinary management of patients with liver metastasis from colorectal cancer.
Kathleen De Greef, Christian Rolfo, +6 authors, Marc Peeters.
World J Gastroenterol, 2016 Sep 14; 22(32). PMID: 27621569    Free PMC article.
Review.
Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer.
Sung Hwan Lee, Sung Hyun Kim, +6 authors, Kyung Sik Kim.
Korean J Hepatobiliary Pancreat Surg, 2016 Sep 14; 20(3). PMID: 27621747    Free PMC article.
Mortality-related risk factors and long-term survival after 4460 liver resections in Sweden-a population-based study.
Stefan Gilg, Ernesto Sparrelid, +3 authors, Cecilia Strömberg.
Langenbecks Arch Surg, 2016 Oct 04; 402(1). PMID: 27695941    Free PMC article.
Clinical outcome of node-negative oligometastatic non-small cell lung cancer.
Kiyohiro Sakai, Masayuki Takeda, +7 authors, Kazuhiko Nakagawa.
Thorac Cancer, 2016 Nov 04; 7(6). PMID: 27755813    Free PMC article.
Simultaneous hepatic resection benefits patients with synchronous colorectal cancer liver metastases.
Yuan Li, Xinyu Bi, +6 authors, Jianqiang Cai.
Chin J Cancer Res, 2016 Nov 24; 28(5). PMID: 27877012    Free PMC article.
Yttrium-90 radioembolization for colorectal cancer liver metastases in KRAS wild-type and mutant patients: Clinical and ccfDNA studies.
E Janowski, O Timofeeva, +6 authors, K Unger.
Oncol Rep, 2016 Dec 23; 37(1). PMID: 28004119    Free PMC article.
Stereotactic Body Radiotherapy for Inoperable Liver Tumors: Results of a Single Institutional Experience.
Hussam Hijazi, Marie-Pierre Campeau, +8 authors, Guila Delouya.
Cureus, 2017 Jan 27; 8(12). PMID: 28123916    Free PMC article.
Enhanced colorectal cancer metastases in the alcohol-injured liver.
Ashley M Mohr, John J Gould, +5 authors, Benita L McVicker.
Clin Exp Metastasis, 2017 Feb 09; 34(2). PMID: 28168393
Pre-therapeutic factors for predicting survival after radioembolization: a single-center experience in 389 patients.
K J Paprottka, F Schoeppe, +7 authors, P M Paprottka.
Eur J Nucl Med Mol Imaging, 2017 Feb 16; 44(7). PMID: 28197686
Post-pulmonary metastasectomy prognosis after curative resection for colorectal cancer.
Jee Yeon Kim, In Ja Park, +8 authors, Jin Cheon Kim.
Oncotarget, 2017 Apr 13; 8(22). PMID: 28402263    Free PMC article.
Morphological response contributes to patient selection for rescue liver resection in chemotherapy patients with initially un-resectable colorectal liver metastasis.
Koichi Suzuki, Yuta Muto, +17 authors, Toshiki Rikiyama.
Oncol Lett, 2017 Aug 10; 14(2). PMID: 28789370    Free PMC article.
The role of vitamin D in hepatic metastases from colorectal cancer.
E Shaw, N Massaro, N T Brockton.
Clin Transl Oncol, 2017 Aug 13; 20(3). PMID: 28801869
Review.
Trans-arterial chemoperfusion for the treatment of liver metastases of breast cancer and colorectal cancer: Clinical results in palliative care patients.
Tatjana Gruber-Rouh, Marcel Langenbach, +4 authors, Martin Beeres.
World J Clin Oncol, 2017 Aug 30; 8(4). PMID: 28848701    Free PMC article.
Prognostic factors after pulmonary metastasectomy of colorectal cancers: a single-center experience.
Ludovic Fournel, Stefania Maria, +7 authors, Marco Alifano.
J Thorac Dis, 2017 Nov 10; 9(Suppl 12). PMID: 29119012    Free PMC article.
An Overview of the Current Management of Bilobar Colorectal Liver Metastases.
Rebecca K L Griggs, Samir Pathak, Graeme Poston.
Indian J Surg Oncol, 2017 Dec 06; 8(4). PMID: 29203994    Free PMC article.
Review.
Stereotactic body radiotherapy for primary and metastatic liver tumors - the Mayo Clinic experience.
Kenneth W Merrell, Jedediah E Johnson, +6 authors, Kenneth R Olivier.
J Radiosurg SBRT, 2016 Jan 01; 4(2). PMID: 29296438    Free PMC article.
Interleukin-1 receptor antagonist inhibits angiogenesis in gastric cancer.
Zhenqiang Gong, Jiachi Ma, +6 authors, Jianbo Du.
Int J Clin Oncol, 2018 Jan 19; 23(4). PMID: 29344744    Free PMC article.
The emerging role of stereotactic radiotherapy in gastrointestinal malignancies: a review of the literature and analysis from the Irish perspective.
Siobhra O'Sullivan, Daniel N Cagney.
Ir J Med Sci, 2018 Feb 10; 187(4). PMID: 29423821
Review.
Late gadolinium enhancement of colorectal liver metastases post-chemotherapy is associated with tumour fibrosis and overall survival post-hepatectomy.
Helen M C Cheung, Paul J Karanicolas, +7 authors, Laurent Milot.
Eur Radiol, 2018 Feb 25; 28(8). PMID: 29476216    Free PMC article.
Phase II trial to investigate the safety and efficacy of orally applied niclosamide in patients with metachronous or sychronous metastases of a colorectal cancer progressing after therapy: the NIKOLO trial.
Susen Burock, Severin Daum, +3 authors, Ulrike Stein.
BMC Cancer, 2018 Mar 17; 18(1). PMID: 29544454    Free PMC article.
MicroRNA hsa-let-7e-5p as a potential prognosis marker for rectal carcinoma with liver metastases.
Wenfeng Chen, Guosheng Lin, +10 authors, Yongjian Zhou.
Oncol Lett, 2018 May 08; 15(5). PMID: 29731866    Free PMC article.
Gadofosveset-enhanced magnetic resonance imaging as a problem-solving tool for diagnosing colorectal liver metastases: a case report.
Helen Cheung, Paul Karanicolas, +2 authors, Laurent Milot.
Quant Imaging Med Surg, 2018 May 19; 8(3). PMID: 29774188    Free PMC article.
Surgical outcome of extended liver resections for colorectal liver metastasis compared with standard liver resections.
Go Shinke, Takehiro Noda, +12 authors, Masaki Mori.
Mol Clin Oncol, 2018 Jul 07; 9(1). PMID: 29977546    Free PMC article.
Current role of transarterial chemoembolization and radioembolization in the treatment of metastatic colorectal cancer.
Lourens Bester, Baerbel Meteling, +2 authors, David L Morris.
Hepat Oncol, 2014 Apr 01; 1(2). PMID: 30190956    Free PMC article.
Review.
Addition of bevacizumab to preoperative chemotherapy for colorectal liver metastases does not increase perioperative morbidity and mortality.
Alexandros Giakoustidis, Kyriakos Neofytou, Aamir Khan, Satvinder Mudan.
Hepat Oncol, 2014 Oct 01; 1(4). PMID: 30190972    Free PMC article.
Factors Affecting Oncologic Outcomes of 90Y Radioembolization of Heavily Pre-Treated Patients With Colon Cancer Liver Metastases.
Ieva Kurilova, Regina G H Beets-Tan, +10 authors, Constantinos T Sofocleous.
Clin Colorectal Cancer, 2018 Oct 10; 18(1). PMID: 30297264    Free PMC article.
Chemotherapy-induced liver injury in metastatic colorectal cancer: about 48 cases.
Faten Limaiem, Saadia Bouraoui.
Pan Afr Med J, 2018 Nov 21; 30. PMID: 30455827    Free PMC article.
Hepatic resection for primary and secondary liver malignancies.
Stefan Heinrich, Hauke Lang.
Innov Surg Sci, 2017 Mar 24; 2(1). PMID: 31579727    Free PMC article.
Review.
Development of novel predictive miRNA/target gene pathways for colorectal cancer distance metastasis to the liver using a bioinformatic approach.
Precious Takondwa Makondi, Po-Li Wei, Chien-Yu Huang, Yu-Jia Chang.
PLoS One, 2019 Feb 27; 14(2). PMID: 30807603    Free PMC article.
Combined resection and radiofrequency ablation for advanced hepatic malignancies: results in 172 patients.
Timothy M Pawlik, Francesco Izzo, +2 authors, Steven A Curley.
Ann Surg Oncol, 2003 Nov 05; 10(9). PMID: 14597445    Free PMC article.
Plasma Exosomal miRNA-139-3p is a Novel Biomarker of Colorectal Cancer.
Wanchao Liu, Dianyu Yang, +6 authors, Dong Li.
J Cancer, 2020 Jul 07; 11(16). PMID: 32626537    Free PMC article.
Resectability and Ablatability Criteria for the Treatment of Liver Only Colorectal Metastases: Multidisciplinary Consensus Document from the COLLISION Trial Group.
Sanne Nieuwenhuizen, Robbert S Puijk, +49 authors, Martijn R Meijerink.
Cancers (Basel), 2020 Jul 09; 12(7). PMID: 32635230    Free PMC article.
Tumor enhancement of colorectal liver metastases on preoperative gadobutrol-enhanced MRI at 5 minutes post-contrast injection is associated with overall survival post-hepatectomy.
Helen M C Cheung, Paul J Karanicolas, +2 authors, Laurent Milot.
Quant Imaging Med Surg, 2019 Apr 13; 9(2). PMID: 30976555    Free PMC article.
Clinical Outcomes and Predictors in Patients With Unresectable Colorectal Cancer Liver Metastases Following Salvage Percutaneous Radiofrequency Ablation: A Single Center Preliminary Experience.
Ying Wang, Guang-Yuan Zhang, +6 authors, Wen-Tao Li.
Technol Cancer Res Treat, 2020 Oct 10; 19. PMID: 33034276    Free PMC article.
Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time.
Lionel Chen, Nicholas L Syn, +8 authors, Jin Yao Teo.
World J Surg Oncol, 2020 Sep 05; 18(1). PMID: 32883292    Free PMC article.
Non-alcoholic fatty liver disease and colorectal cancer survival.
Kana Wu, Mike Z Zhai, +4 authors, Bette J Caan.
Cancer Causes Control, 2018 Nov 18; 30(2). PMID: 30443695    Free PMC article.
Cytoreduction for colorectal metastases: liver, lung, peritoneum, lymph nodes, bone, brain. When does it palliate, prolong survival, and potentially cure?
Camille L Stewart, Susanne Warner, +5 authors, Yuman Fong.
Curr Probl Surg, 2018 Dec 12; 55(9). PMID: 30526930    Free PMC article.
Review.
A Precision Medicine Drug Discovery Pipeline Identifies Combined CDK2 and 9 Inhibition as a Novel Therapeutic Strategy in Colorectal Cancer.
Jason A Somarelli, Roham Salman Roghani, +10 authors, David S Hsu.
Mol Cancer Ther, 2020 Nov 08; 19(12). PMID: 33158998    Free PMC article.
The Role of Neoadjuvant Chemotherapy in Repeat Local Treatment of Recurrent Colorectal Liver Metastases: A Systematic Review and Meta-Analysis.
Madelon Dijkstra, Sanne Nieuwenhuizen, +9 authors, M Petrousjka van den Tol.
Cancers (Basel), 2021 Feb 10; 13(3). PMID: 33561088    Free PMC article.
Review.
Extrahepatic recurrence rates in patients receiving adjuvant hepatic artery infusion and systemic chemotherapy after complete resection of colorectal liver metastases.
Rami M Srouji, Raja R Narayan, +10 authors, Michael I D'Angelica.
J Surg Oncol, 2020 Sep 26; 122(8). PMID: 32976666    Free PMC article.
Patterns and resectability of colorectal cancer recurrences: outcome study within the COLOFOL trial.
P Hansdotter, P Scherman, +5 authors, I Syk.
BJS Open, 2021 Jul 27; 5(4). PMID: 34308474    Free PMC article.
Analysis of factors associated with outcome in patients undergoing isolated hepatic perfusion for unresectable liver metastases from colorectal center.
H Richard Alexander, David L Bartlett, +6 authors, Tatiana H Beresneva.
Ann Surg Oncol, 2009 May 13; 16(7). PMID: 19434456    Free PMC article.
Pulmonary Metastasectomy in Colorectal Cancer: updated analysis of 93 randomized patients - control survival is much better than previously assumed.
M Milosevic, J Edwards, +12 authors, T Treasure.
Colorectal Dis, 2020 May 11; 22(10). PMID: 32388895    Free PMC article.
Primary Tumor Sidedness, RAS and BRAF Mutations and MSI Status as Prognostic Factors in Patients with Colorectal Liver Metastases Treated with Surgery and Thermal Ablation: Results from the Amsterdam Colorectal Liver Met Registry (AmCORE).
Madelon Dijkstra, Sanne Nieuwenhuizen, +10 authors, Martijn R Meijerink.
Biomedicines, 2021 Aug 28; 9(8). PMID: 34440165    Free PMC article.
Repeat Local Treatment of Recurrent Colorectal Liver Metastases, the Role of Neoadjuvant Chemotherapy: An Amsterdam Colorectal Liver Met Registry (AmCORE) Based Study.
Madelon Dijkstra, Sanne Nieuwenhuizen, +10 authors, Monique Petrousjka van den Tol.
Cancers (Basel), 2021 Oct 14; 13(19). PMID: 34638481    Free PMC article.
Prognostic factors after ultrasound-guided percutaneous ablation of colorectal liver metastases: A systematic review.
Jeanett Klubien, Andreas P Kohl, +2 authors, Hans-Christian Pommergaard.
Australas J Ultrasound Med, 2018 Apr 02; 21(2). PMID: 34760508    Free PMC article.
Review.