M. Khurrum1, B. Ryan1, J. Clarke1, D. Schaub2, S. Saeed2, I. Bolakale-rufai2, A. Moreno2, T. Talabi2, S. Kollipara2, V. Nfonsam3 1Westchester Medical Center, Surgery, Westchester, NY, USA 2University Of Arizona, Surgery, Tucson, AZ, USA 3Lousiana State University, Surgery, New Orleans, LA, USA
Introduction:
Surgical management of colon cancer patients with liver metastasis has continued to evolve. Most guidelines recommend hepatectomy or metastasectomy when feasible. Given a paradigm shift of liver directed therapies, the aim of our study is to evaluate survival outcomes among metastatic colon cancer patient who underwent liver resection.
Methods:
A 14-year review (2004-2017) of the National Cancer Database was performed. Patients who underwent hepatectomy for metastatic colon cancer was identified. Baseline patient characteristics including patient demographics, household income, area-based measures, Charlson/Deyo comorbidity score, insurance status were analyzed. Outcome measures included post-surgery 30-day readmissions, 30-day mortality, 1, 3 and 5-year survival. Multivariate regression analysis was performed.
Results:
A total of patients 986,002 patients with colon cancer were analyzed. Overall, 4417 (0.4%) patients were found to have liver metastasis and underwent hepatectomy. Mean age was 60 years and 52% of our study population were male. Patients who underwent hepatectomy for metastatic colon cancer were more likely to be White (80.6%), non-Hispanic (92%), and insured (96%). 75% of patients does not have any medical comorbidities. Almost 14% of patient readmitted to the hospital and 6.5% of patient underwent unplanned surgical interventions. 30 days mortality was 157 (3.6%). Overall, 1, 3 and 5-year survival was 33%, 27% and 12 % respectively. Non-insured status, and higher Charlson-Deyo Score are associated with higher 1 year mortality.
Conclusion:
Despite metastatic liver disease in colon cancer patient, hepatectomy is associated with good prognosis and outcomes. Due to the increasing complexity of surgical interventions for metastatic colon cancer and higher disease burdens, future studies should explore more granular outcomes following hepatectomy in metastatic colon cancer patients.