Impact of Surgical Factors and Postoperative Immune Status on Prognosis After Resection of Colorectal Liver Metastasis

BACKGROUND/AIM: This study aimed to evaluate the impact of surgical factors and postoperative complications on survival after resection of colorectal liver metastases and to identify postoperative prognostic immune markers. PATIENTS AND METHODS: We retrospectively reviewed 118 patients who underwent hepatic resection for colorectal liver metastases at our institution. Patients were stratified according to surgical factors, and the prognostic significance of perioperative neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) was analyzed. RESULTS: Survival was significantly poorer in patients with postoperative complications, prolonged operative time, and increased blood loss. In univariate analysis, multiple liver metastases, poor differentiation or mucinous histology, postoperative complications, operative time >300 min, and blood loss >320 ml were associated with worse overall survival. Multivariate analysis identified multiple liver metastases, poor differentiation or mucinous histology, postoperative complications, operative time >300 min, and blood loss >320 ml as independent prognostic factors. Postoperative LMR was significantly associated with both overall and disease-free survival. CONCLUSION: Postoperative complications, operative time, and blood loss were independent predictors of prognosis after resection of colorectal liver metastases. Postoperative LMR may serve as a simple and clinically useful marker of host immune status. Efforts to minimize operative time, blood loss, and postoperative complications may contribute to improved long-term outcomes.