Prognosis of untreated liver metastasis from rectal cancer

Majority of studies based of treatment of liver metastases from colorectal cancer compare their results to historical controls that include patients having untreated secondary liver tumours. The aim of this study was to show the natural history of patients with liver metastasis from rectal cancer. Data of 303 patients underwent laparotomy between 1984 and 1992 were reviewed. 47 of 57 patients who had liver metastasis at the time of surgery fulfilled the criteria of the study. The mean survival time was 8.5 (1-27) months for all patients, 11 months for patients with solitary hepatic tumour (n = 13) and 7.5 months for those with multiple tumours (n = 34). Patients who had liver and other distant metastases simultaneously (n = 9) survived a shorter time than those with hepatic secondaries only (4 and 9 months respectively). The mean survival time for patients in whom the primary tumour was resected (n = 17) was 11 months contrary to 7 months for those who underwent colostomy or exploratory laparotomy, but comparison of survival curves didn't revealed significant difference between the two groups.

The incidence of liver metastases from rectal cancer at the time of laparotomy was 19%. The prognosis was very poor in case of synchronous secondary tumours. Palliative resection of the primary tumour is recommended for selected patients only to control local symptoms.