BACKGROUND: Metastatic colorectal cancer is a major cause of cancer death in North America. Hepatic resection offers the potential for cure in selected patients. We report the long-term outcomes of patients who underwent hepatic resection for colorectal metastases over a 10-year period at a single hepatobiliary surgical oncology center. METHODS: All patients who underwent liver resection for metastatic colorectal cancer between 1992 and 2002 were identified. Data were retrospectively obtained through chart review. Major outcome variables were disease-free survival and overall survival. Risk factors for disease recurrence and mortality were identified by multivariate analysis by using the Cox proportional hazard method. RESULTS: A total of 423 hepatectomies were performed for metastatic colorectal cancer. Most operations (n = 276; 65%) were major (four or more segments) hepatectomies. Perioperative morbidity occurred in 74 (17%) patients. There were seven (1.6%) perioperative deaths. The disease-free survival at 1, 5, and 10 years was 64%, 27%, and 22%, respectively. The overall survival at 1, 5, and 10 years was 93%, 47%, and 28%, respectively. Multivariate analysis identified four negative predictive factors for overall survival (hazard ratio; 95% confidence interval): a positive surgical margin (2.9; 1.5-5.3), large metastases (>5 cm; 1.5; 1.1-2.0), multiple metastases (1.4; 1.1-1.9), and age >60 years (1.4; 1.1-1.9). CONCLUSIONS: Hepatic resection for metastatic colorectal cancer is safe and provides good long-term overall survival rates of 47% at 5 years and 28% at 10 years. An aggressive approach is justified by the low operative mortality rate and good long-term survival, even in individuals with multiple bilobar metastases.
BACKGROUND: Metastatic colorectal cancer is a major cause of cancer death in North America. Hepatic resection offers the potential for cure in selected patients. We report the long-term outcomes of patients who underwent hepatic resection for colorectal metastases over a 10-year period at a single hepatobiliary surgical oncology center. METHODS: All patients who underwent liver resection for metastatic colorectal cancer between 1992 and 2002 were identified. Data were retrospectively obtained through chart review. Major outcome variables were disease-free survival and overall survival. Risk factors for disease recurrence and mortality were identified by multivariate analysis by using the Cox proportional hazard method. RESULTS: A total of 423 hepatectomies were performed for metastatic colorectal cancer. Most operations (n = 276; 65%) were major (four or more segments) hepatectomies. Perioperative morbidity occurred in 74 (17%) patients. There were seven (1.6%) perioperative deaths. The disease-free survival at 1, 5, and 10 years was 64%, 27%, and 22%, respectively. The overall survival at 1, 5, and 10 years was 93%, 47%, and 28%, respectively. Multivariate analysis identified four negative predictive factors for overall survival (hazard ratio; 95% confidence interval): a positive surgical margin (2.9; 1.5-5.3), large metastases (>5 cm; 1.5; 1.1-2.0), multiple metastases (1.4; 1.1-1.9), and age >60 years (1.4; 1.1-1.9). CONCLUSIONS: Hepatic resection for metastatic colorectal cancer is safe and provides good long-term overall survival rates of 47% at 5 years and 28% at 10 years. An aggressive approach is justified by the low operative mortality rate and good long-term survival, even in individuals with multiple bilobar metastases.
Authors: A A J M Van Tilborg; M R Meijerink; C Sietses; J H T M Van Waesberghe; M O Mackintosh; S Meijer; C Van Kuijk; P Van Den Tol Journal: Br J Radiol Date: 2010-12-15 Impact factor: 3.039
Authors: Boudewijn E Schaafsma; J Sven D Mieog; Merlijn Hutteman; Joost R van der Vorst; Peter J K Kuppen; Clemens W G M Löwik; John V Frangioni; Cornelis J H van de Velde; Alexander L Vahrmeijer Journal: J Surg Oncol Date: 2011-04-14 Impact factor: 3.454
Authors: Betul Berber; Rafael Ibarra; Laura Snyder; Min Yao; Jeffrey Fabien; Michael T Milano; Alan W Katz; Karyn Goodman; Kevin Stephans; Galal El-Gazzaz; Federico Aucejo; Charles Miller; John Fung; Simon Lo; Mitchell Machtay; Juan Sanabria Journal: HPB (Oxford) Date: 2013-01-14 Impact factor: 3.647
Authors: Karin Nielsen; Aukje A J M van Tilborg; Martijn R Meijerink; Matessa O Macintosh; Babs M Zonderhuis; Elly S M de Lange; Emile F I Comans; Sybren Meijer; M Petrousjka van den Tol Journal: World J Surg Date: 2013-06 Impact factor: 3.352
Authors: Renato Gomes Campanati; João Bernardo Sancio; Lucas Mauro de Andrade Sucena; Marcelo Dias Sanches; Vivian Resende Journal: Arq Bras Cir Dig Date: 2021-06-11