AUTHORS: Adewale AbdulwasiuAderounmu MD1, Funmilola Olanike Wuraola MD 1, Tajudeen Olakunle Mohammed MD 1, Olalekan O Olasehinde MD 1, Fatima Biade Abdulkareem MD 2, Samuel Adegboyega Olatoke MD 3, Chukuma Eze Okereke MD 4, Mobolaji Adewale Oludara MD 5, Olawale Ayodele Badejo MD 6, Bata Mtaku Gali MD 7, Oluwabusayomi Roseline Ademakinwa PhD8, Christopher Oluwasesan Bamidele MSc8, Peter T Kingham MD9, Olusegun Isaac Alatise MD1,9, ARGO consortium9. 1Obafemi Awolowo University Teaching Hospitals Complex; 2Lagos University Teaching Hospital; 3University of Ilorin Teaching Hospital; 4Federal Medical Centre, Owo; 5Lagos State University Teaching Hospital; 6National Hospital Abuja; 7University of Maiduguri Teaching Hospital; 8African Research Group for Oncology; 9Global Cancer Disparity Initiative, Memorial Sloan Kettering Cancer Center
Introduction: Colorectal cancer (CRC) incidence is rising in sub-Saharan Africa, with over 30% of Nigerian patients presenting with metastatic disease. Data on the patterns, diagnosis, and outcomes of colorectal liver metastases (CRLM) in Nigeria are scarce. Such data can inform treatment planning and elucidate regional differences in CRC biology. This study described the clinicopathologic features, treatment, and survival outcomes of CRLM in a large cohort from Nigeria.
Methods: We retrospectively reviewed a prospectively maintained CRC registry spanning seven Nigerian hospitals from November 2013 to March 2025. Adults (≥18 years) with histologically confirmed CRC and documented liver metastases were included. Extracted data included demographics, primary tumor location, timing of metastases, diagnostic modality, and survival outcomes.
Results: Of 1,315 CRC patients, 464 (35.3%) had metastatic disease, and of this, 272 (58.6%) had liver-only metastases. The vast majority of CRLM were synchronous (97.1%; n=264). Diagnosis of CRLM was made with abdominal ultrasound in 30.4%, abdominal CT in 56.0%, and incidental laparotomy findings in 13.5%. The mean age at CRLM diagnosis was 56.5 ± 15.3 years; 59.4% were male. The distribution of primary tumor locations was as follows: rectum (48.2%), sigmoid colon (18.0%), left colon (8.5%), transverse colon (3.7%), right colon (18.0%), and cecum (3.7%). The median survival time ofthe patients with CRLM is 8 months.
Conclusion: In this multicenter Nigerian cohort, over half of patients with metastatic CRC present with CRLM, predominantly synchronous. Survival remains poor, highlighting an urgent need for earlier detection, wider access to advanced imaging, and strengthened multidisciplinary care to improve outcomes in Nigeria.
