A new classification scheme for recurrent or metastatic colon cancer after liver metastasectomy

Background: Metastasectomy is the standard treatment for patients with resectable liver metastasis from colon cancer. This study aimed to determine the impact of initial stage on overall survival (OS) after metastasectomy. Methods: A retrospective analysis of 2804 patients diagnosed with colon cancer between 1999 and 2008. Results: Of the cohort, 38.1% of the patients were stage IV or had recurrence after curative surgery, and 131 received liver metastasectomy. The 5-year survival rate for patients after liver metastasectomy was 42.1%. The 5-year survival rates after metastasectomy for initial stage I disease, stage H disease, stage III disease, and stage IV disease were 100%, 82.5%, 31.8%, and 36.9%, respectively (p = 0.014). When patients were grouped as initial stage I/II and stage III/IV, the 5-year survival rate after liver metastasectomy differed significantly (83.9% vs. 35.7%, p = 0.006). Patients with initial stage I/II disease after liver metastasectomy had a significantly better 5-year progression-free period compared to those with stage III/IV disease (60% vs. 28%, p = 0.021), which was due to the lower recurrence rate in the stage I/II group. Conclusion: Our results suggest that patients who receive liver metastasectomy for metastatic colon cancer should be grouped into two groups: those with initial stages I and II disease, and those with stages III and IV disease, since the progression-free survivals (PFS) and OS after metastasectomy in these two groups differ significantly. Copyright (C) 2011 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.