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Updated: Mar 16, 2026
The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
The Impact of Surgical Resection in Early Onset Colorectal Cancer Patients With Liver Limited Disease
Andrea Pretta1, Pina Ziranu1, Francesca Bergamo2
1Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy.
Background:
Recent studies have shown an increased incidence of early-onset CRC (EO-CRC), particularly in advanced stages and with metastatic disease. Our study aimed to evaluate the role of metastasectomies related to the clinical and molecular characteristics of EO-CRC patients with liver metastases compared to average-onset CRC (AO-CRC) patients.
Methods:
We retrospectively collected data from 1123 stage IV colorectal cancers, including 782 with liver metastases, from 5 different Italian institutions. The main objective of the study was to compare the overall survival of liver metastatic EO-CRC and AO-CRC patients who underwent metastasectomy versus those who were not resected.
Results:
Liver resected EO-CRCs patients showed a statistically significant lower mOS than liver resected AO-CRCs (44.0 vs. 64.0 months, P < .0001). mPFS was also statistically significant lower in EO-CRCs (13.0 vs. 17.0, P < .0001). Same outcomes were found in RAS mut subgroup (37.0 vs. 52.0 months, P < .0001) and in RAS/BRAF wild-type subgroup (50.0 vs. 81.0 months, P < .0001). EO-CRC patients showed a higher prevalence of TP53 alterations (56.2%) and a lower of APC mutation (29.9%). EO-CRCs presented a higher frequency of ARID1A (4.4%) and CTNNB1 (3.0%) alterations.
Conclusion:
The results indicate a worse overall prognosis for EO-CRC patients undergoing metastasectomy compared to average-onset patients. This outcome appears to occur independently of the molecular status. These observations could have a considerable impact on clinical practice and research.
