Management of colorectal hepatic metastases in the Veterans Affairs medical system: Opportunities for curative intent surgery.

e14541 Background: Surgical resection of isolated liver metastases in colon cancer offers the greatest chance of long-term survival. An initial 15-20% of patients are resectable with an additional 10-30% after conversion chemotherapy. We aimed to study surgical intervention rates and survival outcomes in the Veterans Affairs Medical System. Methods: A retrospective analysis of stage IV colon cancer and isolated liver metastases from 10/01/2004-12/31/2012 nationwide was performed using the VA Central Cancer Registry (VACCR) and patient level clinical data via Veterans Affairs Informatics and Computing Infrastructure (VINCI). Kaplan-Meier analysis was used to examine differences in time from diagnosis to death by surgery status. Cox regression was then used with age at diagnosis as a covariate. All analysis was done using SAS (version 9.3, Cary, NC), and p<.05 was considered significant. Results: We identified 1727 cases of stage IV colon cancer and isolated hepatic metastases. Hemicolectomy was carried out...