Multicenter cohort study of timing of detection of liver metastases and survival in patients with colorectal cancer

Colorectal cancer liver metastases (CRLM) are a common manifestation of colorectal cancer, The timing of CRLM detection, defined as synchronous, early metachronous (within 12 months of the primary diagnosis), or late metachronous, is hypothesized to influence survival outcomes, but the prognostic implications of these classifications remain unclear. A multicenter cohort study in The Netherlands investigated the association of the timing of CRLM detection with overall survival (OS). In this study of 1250 patients, 817 (65%) had synchronous CRLM, 208 (17%) had early metachronous CRLM, and 225 (18%) had late metachronous CRLM. Patients were followed-up for a median of 44 months (IQR 41-48). In unadjusted analyses, patients with synchronous CRLM had worse survival. However, timing of detection was not an independent factor after adjusting for tumor number, size, variant status, CEA levels, and treatment strategy. The ability to undergo local treatment had the greatest association with improved survival. The authors conclude that these findings suggest synchronicity is not independently associated with survival.