Biomarkers and Prognosis after R0 Resection of Colorectal Liver Metastases

Background: Evaluation of biomarkers and clinical factors associated with cancer-specific survival after curative resection for colorectal cancer liver metastases (LM). Methodology: All patients who had an R0 resection for LM between 2000-2006 were reviewed. Clinical and histological data were assessed; p53 expression was studied by IHC. ERCC1 codon 118 and XRCC1 codon 399 were analyzed by PCR-RFLP using BsrDI and HpaII, respectively. Results: Out of 119 patients included (80 synchronous LM (67.2%), median number 2 (1-18)), 104 patients (87.4%) received chemotherapy before recurrence; 60 patients (50.4%) had a p53 negative tumor. ERCC1 distribution was: 31(26%) AAC/AAC, 44(37%) AAC/AAT and 44(37%) AAT/AAT. XRCC1 distribution was: 46(39%) CGG/CGG, 53(44.9%) CGG/CAG and 19(16.1%) GAG! CAG. Three and 5-years disease free survival (DFS) and overall survival (OS) were 31%, 22.7%, 77.4%, and 66.6%, respectively. Node ratio >0.2 (p = 0.0042), LM number >3 (p <0.0001), bilobar localization (p = 0.0074) and preoperative chemotherapy (p = 0.0036) were associated with a shorter DFS. None of the biomarkers was found to influence DFS. In multivariate analysis, a number of LM >3 was the only independent factor. No factor was found to influence OS. Conclusions: The studied biomarkers had no significant impact on prognosis. For routine practice, clinical factors remain the only usable available tools.