Effects of Surgery and Palliative Chemotherapy in the Treatment of Colorectal Liver Metastasis

Purpose: 1) to compare the survival of patients with colorectal liver metastases who underwent resection as the primary treatment against patients who had chemotherapy as the primary treatment; 2) to compare the survival in patients with recurrent inoperable liver metastases (after resection) treated with Oxaliplatin or Irinotecan against those patients with inoperable recurrence who were treated with 5-FU. Patients and Methods: 538 patients with colorectal liver metastases were referred to our unit between November 1997 and May 2005; 247 underwent liver resection and 291 had palliative chemotherapy. Results: only 7.8% of non-operated patients survived for 5 years compared to 32.9% of the liver resection group. After surgery, 191 patients developed inoperable recurrent disease. These patients were treated with chemotherapy; Ox/Ir patients had a 3 year survival of 55% compared to 32% of those who received 5-FU. Our data shows that in patients who relapse after liver surgery, chemotherapy with Oxaliplatin or Irinotecan confers a significant survival benefit.