• Frank Makowiec, Magdalena Menzel, Peter Bronsert, Philipp A Holzner, Andrea Klock, Sven A Lang, Stefan Fichtner-Feigl, and Hannes P Neeff.
• Department of General and Visceral Surgery, Center for Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Department of Governance and Clinical Risk Management, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
• Dig Liver Dis. 2018 Oct 1; 50 (10): 1088-1092.

IntroductionIn unresectable patients with metastatic colorectal cancer (CRC), the site of the primary is a strong prognostic factor warranting major adjustments in palliative medical treatment. Initial results suggested that the site of CRC influences prognosis after curative resection of colorectal liver metastases (CLM). In this study, we evaluated outcome after resection of isolated CLM with regard to the location of the primary.Methods221 patients with macroscopically complete resection of CLM and no known extrahepatic disease were identified. 63 patients had right-sided and 158 had left-sided CRC. Tumors of the transverse colon and rectum were excluded. Survival was evaluated using the Kaplan-Meier method.ResultsCharacteristics of CLM, primary tumor stage and chemotherapeutic regimens were not significantly different between the two groups. Kaplan-Meier five-year survival was comparable (41%) in patients with right- or left-sided CRC (p = 0.64). Microscopic resection margin, number of liver metastases, age and nodal status but not the site of the primary tumor significantly influenced survival.ConclusionThe site of the colorectal primary in this well-defined group of patients after resection of isolated CLM did not prove to be of significant prognostic value. Whether the primary tumor in CLM is located on the left side or the right should not preclude patients from surgery.Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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