Patients with colorectal cancer who survive ten years after surgery to remove metastatic liver tumors can be considered cured, according to a retrospective study conducted by Memorial Sloan-Kettering investigators. The findings appeared in the October 10 issue of the Journal of Clinical Oncology. [PubMed Abstract]
The liver is the most common site of colorectal cancer metastases, which can appear even after the primary tumor has been removed. For patients with liver tumors that are operable, surgery has emerged as the standard of care. It is offered as the only chance of a cure for patients with liver metastases, though the curative potential of surgery alone has become increasingly difficult to assess due to the advent of modern chemotherapy drugs to help treat metastases.
In an effort to define the curative potential of surgery, a Memorial Sloan-Kettering team led by surgical oncologist Michael D'Angelica examined the long-term outcomes of more than 600 colorectal cancer patients who underwent surgery for colorectal liver metastases between 1985 and 1994. All patients had their primary colorectal tumors surgically removed. Using long-term data -- the median follow-up for the 102 ten-year survivors was 146 months -- the team found that less than 1 percent of these patients experienced a cancer-related death, compared with one-third of patients who survived five years. The study's authors concluded that ten-year survival appears to be a predictor of cure for colorectal patients with liver metastases.
Dr. D'Angelica emphasized that the data for the study were derived from a patient population treated before the introduction of modern chemotherapeutic agents. "These long-term survivals -- in an era of minimally effective or ineffective chemotherapy -- are proof of principle that surgery for this disease is potentially curative," he said. However, Dr. D'Angelica also stressed the value of newer drugs in treating metastatic disease. "Certainly the hope for the future is novel combinations of surgery and systemic chemotherapy."
