Liver Metastases and Survival Among Patients With Colorectal Cancer

Area of Science:

• Oncology
• Epidemiology
• Public Health

Background:

• Colorectal liver metastases (CRLM) are a primary cause of mortality in colorectal cancer (CRC) patients.
• Understanding CRLM incidence and survival patterns is crucial for clinical management and health policy development.

Purpose of the Study:

• To investigate temporal trends in the incidence, characteristics, and survival rates of patients with synchronous and metachronous CRLM.
• To analyze survival outcomes based on the timing of liver metastasis relative to the primary CRC diagnosis.

Main Methods:

• A population-based cohort study utilizing Danish national health registries from 2007 to 2024.
• Included 14,785 patients diagnosed with CRLM, with a nested medical record review for 954 patients.
• Analyzed cumulative incidence and overall survival using Kaplan-Meier curves and Cox regression, comparing outcomes across diagnosis periods and CRLM subtypes.

Main Results:

• The 5-year cumulative incidence of CRLM was 19.8%, decreasing with age but highest in patients under 50 and males.
• One-year survival for synchronous CRLM improved from 47.2% (2007-2010) to 58.3% (2020-2024).
• Five-year survival for synchronous CRLM improved from 13.0% to 20.7% over the same periods; no survival improvement was noted for late metachronous CRLM.

Conclusions:

• CRLM incidence has decreased, while survival has improved for synchronous and early metachronous disease.
• Lack of survival improvement in late metachronous CRLM may indicate distinct biological or treatment-related factors.
• Findings support the development of targeted follow-up and treatment strategies based on metastasis timing.