Prognostic Factors Influencing Survival After Liver Resection for Colorectal Metastases
摘要
Colorectal cancer frequently metastasizes to the liver, where surgical resection remains the only potentially curative treatment. Despite advances in perioperative care, survival after liver resection remains variable and is largely influenced by clinicopathological characteristics and tumor biology. This study aimed to identify prognostic factors associated with survival after hepatic resection for colorectal liver metastases. A retrospective cohort study was conducted on 105 patients who underwent curative-intent liver resection between 2006 and 2017. Demographic, pathological, and surgical variables were evaluated, and survival outcomes were estimated using the Kaplan–Meier method with log-rank testing. The mean overall survival was 37.6 SD25.6 months, and the mean disease-free survival was 25.7 SD24.4 months over a follow-up period ranging from 12 to 154 months. The three- and five-year overall survival rates were 51% and 32%, respectively. Patient age, histological type, differentiation grade, lymph node status, preoperative carcinoembryonic antigen level, size of metastatic lesions, surgical margin status, and extent of hepatectomy were significantly associated with overall survival (p < 0.001). Disease-free survival was similarly affected by age, differentiation, lymph node status, carcinoembryonic antigen level, metastasis size, extent of resection (p < 0.001) and the diagnostic timing of metastasis (p = 0.011). Primary tumor location, interval between resections, bilobar involvement, and number of metastases showed no significant association with outcome. These findings underscore that, while surgical precision remains essential, the influence of tumor biology and molecular markers on long-term prognosis is undeniable.