Prognostic factors in patients with colorectal cancer and isolated potentially resectable or unresectable liver metastases

Objective: to evaluate prognostic factors in patients with metastatic colorectal cancer (mCRC) and isolated liver metastases, and to analyze the role of systemic therapy in achieving resectability and the impact of surgical treatment on survival outcomes.
Materials and methods. A retrospective study of 371 patients with mCRC and initially unresectable isolated liver metastases. Resectability was assessed by a multidisciplinary tumor board. Patients received systemic chemotherapy with targeted agents (bevacizumab or anti-EGFR). Progression-free survival (PFS), conversion rates, and prognostic factors were analyzed using univariate and multivariate methods.
Results. The conversion rate to resectability was 60.1 % (potentially resectable metastases) and 25.9 % (unresectable metastases). Median PFS was 11.3 months (12.7 months for resectable vs. 10.5 months for unresectable). R 0 resection was achieved in 78.8 % and 72.4 % of patients, respectively. Multivariate analysis identified favorable prognostic factors: primary tumor resection and disease stabilization/partial response to therapy. Poor prognostic factors included unresectable metastases and limited/non-countable metastatic lesions.
Conclusions. A combined systemic and surgical approach improves survival in mCRC patients, particularly after successful conversion of initially unresectable metastases.

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21. Authors’ contributions. G. G. Makiev: study concept and design, data collection and analysis, manuscript writing; A. B. Dopchut: data collection; R. Sh. Abdulayeva: data collection; G. M. Naydin: data collection; E. S. Obarevich: data collection and analysis; N. S. Besova: data collection and analysis; A. N. Polyakov: data collection and analysis; M. Yu. Fedyanin: data collection and analysis; A. A. Tryakin: study concept, final editing of the manuscript, data collection.