Survival in patients with synchronous liver metastases in central and northern Denmark, 1998 to 2009

Abstract

Objective

In Denmark, the strategy for treatment of cancer with metastases to the liver has changed dramatically during the period 1998 to 2009, when multidisciplinary care and a number of new treatments were introduced. We therefore examined the changes in survival in Danish patients with colorectal carcinoma (CRC) or other solid tumors (non-CRC) who had liver metastases at time of diagnosis.

Study design and methods

We included patients diagnosed with liver metastases synchronous with a primary cancer (ie, a solid cancer diagnosed at the same date or within 60 days after liver metastasis diagnosis) during the period 1998 to 2009 identified through the Danish National Registry of Patients. We followed those who survived for more than 60 days in a survival analysis (n = 1021). Survival and mortality rate ratio (MRR) at 1, 3, and 5 years stratified by year of diagnosis were estimated using Cox proportional hazards regression analysis.

Results

In the total study population of 1021 patients, 541 patients had a primary CRC and 480 patients non-CRC. Overall, the 5-year survival improved from 3% (95% confidence interval [CI]: 1%–6%) in 1998–2000 to 10% (95% CI: 6%–14%) in 2007 to 2009 (predicted value). The 5-year survival for CRC-patients improved from 1% (95% CI: 0%–5%) to 11% (95% CI: 6%–18%) whereas survival for non-CRC patients only increased from 5% (95% CI: 1%–10%) to 8% (95% CI: 4%–14%).

Conclusion

We observed improved survival in patients with liver metastases in a time period characterized by introduction of a structured multidisciplinary care and improved treatment options. The survival gain was most prominent for CRC-patients.

Keywords:

• liver metastases
• colorectal cancer
• noncolorectal cancer
• survival improvement

Acknowledgments

The study received financial support from the Karen Elise Jensen Foundation, Department of Clinical Epidemiology’s Research Foundation and the Regional Clinical Epidemiological Monitoring Initiative for Central and North Denmark Regions.

Disclosure

Morten Høyer is supported by grants from AP Møller and hustru Chastine McKinney Møllers Fond for Almene Formål og the Lundbeck Foundation Centre for Interventional Research in Radiation Oncology (CIRRO).