The Surgical Outcome and Prognostic Factors for Solitary Colorectal Liver Metastasis

Abstract Background: The study focused on patients who had surgery for solitary liver metastasis of colorectal cancer (CRLM) and experienced relapse. Its main objective was to analyze the factors that independently contribute to recurrence and long-term overall survival. Methods: We retrospectively analyzed 230 solitary CRLM patients who received liver resection between 2010 and 2019. Factors prognostic of disease recurrence and overall survival were investigated and nomograms were developed to predict patient outcome after liver resection. Results: For these patients, the 3-year-overall survival (OS) rate was 72.3% and 59.8% for 5-years. For the recurrence-free survival (RFS) rate, it was 40.0% for 3-years and 27.1% for 5-years. The multivariate analysis showed that age ≥ 70, resection margin width < 10 mm, initial N2 stage, hypoalbuminemia before liver resection, and neutrophil-lymphocyte ratio (NLR) ≥ 3 after liver resection were independent prognostic factors for OS. For RFS, the multivariate analysis showed that initial N2 stage, hypoalbuminemia before liver resection, NLR ≥ 3 after liver resection, abnormal Carcinoembryonic antigen (CEA) after liver resection, and CEA ratio (after/before liver resection) < 0.3 were independent prognostic factors. Conclusions: The study found that several factors significantly impact both the recurrence and overall survival rates of patients who had surgery for solitary liver metastasis of colorectal cancer. The most important risk factors identified were the initial N2 stage, a neutrophil-lymphocyte ratio of 3 or higher after liver resection, and hypoalbuminemia (albumin levels below 3.5 g/dL) before liver resection.