Natural history of colorectal carcinoma with untreated liver metastases

In a series of 474 patients operated on for colonic and rectal carcinoma, 65 were shown to have hepatic metastases. Factors influencing spontaneous survival were evaluated in 56 patients. This study emphasizes the dominant role of the amount of liver involvement. A clinical staging referring to the size and number of liver deposits, to the presence or absence of jaundice and/or malignant ascites, and to liver function tests abnormalities provides an available classification which can be closely related to the outcome of such patients. Thus, it yields a valuable basis to avoid misleading prognostic data and to substantiate the effectiveness of aggressive treatments in case of carefully selected patients.