Prognostic value of different surgical treatment strategies in patients with colorectal cancer liver metastases

Objective: This study aimed to evaluate the prognostic value of different surgical treatment options selected based on the clinical and pathological characteristics of colorectal liver metastasis (CLM) patients through a retrospective study. Materials and Methods A retrospective analysis was conducted on CLM patients from 2000 to 2018 based on the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate regression analysis and propensity score matching were used to evaluate the survival outcomes and risk factors of different surgical treatment strategies. Results A total of 32,308 eligible CLM patients were included in this study, with 15,409 (47.69%) patients receiving no surgery, 469 (1.45%) patients undergoing liver cancer surgery only without colorectal cancer surgery, 11,559 (35.78%) patients undergoing colorectal cancer surgery only without liver cancer surgery, and 4,871 (15.08%) patients undergoing both liver cancer and colorectal cancer surgery. Multivariate survival analysis showed that patients who underwent both surgeries had the best prognosis, while patients who underwent only liver cancer surgery or only colorectal cancer surgery had similar survival curves, indicating similar prognostic outcomes. Patients who did not undergo surgery had the worst prognosis (P < 0.001). Propensity score matching eliminated potential confounding factors and verified the aforementioned findings. Conclusion In all conditions, even when only partial conditions meet the indications for surgery, proactive surgical treatment remains the primary choice with adequate consideration for safety. Personalized surgical resection strategies contribute to improved survival rates for patients.