Reviewed By: Pramod Kerkar, MD, FFARCSI

What Is The Prognosis For Liver Metastases?

Prognosis is a clinical term describes the development of a disease, including the signs and symptoms or its stability over time; expectations of quality of life, such as the ability to carry out daily activities; the potential for complications and associated health issues; and the likelihood of survival. In short, it is defined as the expected duration, function, and description of the course of the disease, such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.

Factors For Prognosis

Prognosis of metastases to the liver include the success of any surgical removal that may have been performed; the cancerous state of lymph nodes surrounding the portal veins; the extent of disease outside the liver; multiple numbers of metastases or stage of primary cancer.

What Is The Prognosis For Liver Metastases?

Liver metastases often referred to as "secondary liver cancer" which occurs in the colon, breast, lung, pancreas, or the gastrointestinal tract of the person and spread to the liver. The life expectancy for secondary liver cancer or liver metastases depends upon the extent of spread of primary cancer, patient’s age, and immune status. Without treatment, patients who develop liver metastases live an average of 8.7 months.

Metastatic Breast Cancer

Liver metastases are found in 6 to 25% of patients with metastatic breast cancer. Median survival noted in breast cancer liver metastasis i.e. only a few months and rarely 5-year survival. Median survival was 4.23 months (range 0.16–51), with a 27.6% 1-year survival. The factors that significantly affect the patients include jaundice, an elevated level of liver enzymes, the incidence of ascites, histological grade 3 disease at primary presentation, advanced age, estrogen receptor (ER) negative tumors, the carcinoembryonic antigen of over 1000 ng ml−1 and multiple liver metastases.

Colorectal Cancer Liver Metastases

Liver metastases from colorectal cancer carry a median survival of 5 to 20 months if left untreated; two-year survival is unusual, and five-year survival is extremely rare. Factors associated with a significant disadvantage in the unresected group include the extent of liver disease, the presence of extrahepatic disease, the age of the patient, and carcinoembryonic antigen (CEA) level. Though most patients with colorectal liver metastases have a poor prognosis, some patients can still benefit from radical surgery and possibly even avoid recurrence.

Neuroendocrine Liver Metastases

In neuroendocrine liver metastases, the excess hormone production, the multitude of hepatic lesions, and ultimate liver disease has made the condition poor prognosis. Patients with liver metastases have a significantly worse prognosis and 5-year survival of patients with neuroendocrine liver metastases on supportive care is 0% to 20%.

Some Example For Dismal Prognosis

The prognosis of patients with liver metastases from gastric cancer is depressing, and little is known about prognostic factors in these patients; so the justification for surgical resection is still controversial. Liver metastases develop in approximately 10% of patients with renal tumors, and they have a dismal prognosis:

Forms of Prognostic Scoring

Prognostic scoring is also used for cancer outcome predictions. A Manchester score is an indicator of prognosis for small-cell lung cancer. For Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome. Other medical areas where prognostic indicators are used is in Drug-Induced Liver Injury and use of an exercise stress test as a prognostic indicator after myocardial infarction, also use to indicator multiple myeloma survive rate.

Conclusion

Liver metastases are observed in patients with breast, lung, and pancreatic cancers. However, liver metastases are most commonly found in patients with metastatic colorectal cancer followed by neuroendocrine liver metastases. Liver metastases historically confer a poor prognosis, often less than a year. However, there is significant variability based on tumor type, treatment options, and comorbid disease.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: June 28, 2018

This article does not provide medical advice. See disclaimer

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