OBJECTIVE(S): To investigate rates and patterns of recurrence in patients following curative intent surgery for colorectal liver metastasis. BACKGROUND: Outcomes following surgical management of colorectal liver metastasis have largely focused on overall survival. Contemporary data on rates and patterns of recurrence following surgery for colorectal liver metastasis are limited. METHODS: One thousand six hundred sixty-nine patients treated with surgery (resection +/- radiofrequency ablation [RFA]) for colorectal liver metastasis between 1982 and 2008 were identified from an international multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: At the time of the initial liver-directed surgery, surgical treatment was resection only (90.2%), resection plus RFA (8.0%), or RFA alone (1.8%). While 5-year overall survival was 47.3%, 947 (56.7%) patients recurred with a median RFS time of 16.3 months. First recurrence site was intrahepatic only (43.2%), extrahepatic only (35.8%), intra- and extrahepatic (21.0%). There was no difference in RFS based on site of recurrence (intrahepatic: 16.9 months; extrahepatic: 16.6 months; intra- and extrahepatic: 16.2 month; P > 0.05). Receipt of adjuvant chemotherapy was associated with overall recurrence risk (hazard ratio [HR] = 0.56), while history of RFA (HR = 2.39, P = 0.001) and R1 margin status (HR = 1.36) were predictive of intrahepatic recurrence. Pattern of recurrence and RFS remained similar following repeat surgery for recurrent disease. CONCLUSIONS: While 5-year survival following surgery for colorectal liver metastasis approaches 50%, over one-half of patients develop recurrence within 2 years. The pattern of failure is distributed relatively equally among intrahepatic, extrahepatic, and intra- plus extrahepatic sites. Patients undergoing repeat surgery for recurrent metastasis have similar patterns of recurrence and RFS time.
OBJECTIVE(S): To investigate rates and patterns of recurrence in patients following curative intent surgery for colorectal liver metastasis. BACKGROUND: Outcomes following surgical management of colorectal liver metastasis have largely focused on overall survival. Contemporary data on rates and patterns of recurrence following surgery for colorectal liver metastasis are limited. METHODS: One thousand six hundred sixty-nine patients treated with surgery (resection +/- radiofrequency ablation [RFA]) for colorectal liver metastasis between 1982 and 2008 were identified from an international multi-institutional database. Clinicopathologic data, recurrence patterns, and recurrence-free survival (RFS) were analyzed. RESULTS: At the time of the initial liver-directed surgery, surgical treatment was resection only (90.2%), resection plus RFA (8.0%), or RFA alone (1.8%). While 5-year overall survival was 47.3%, 947 (56.7%) patients recurred with a median RFS time of 16.3 months. First recurrence site was intrahepatic only (43.2%), extrahepatic only (35.8%), intra- and extrahepatic (21.0%). There was no difference in RFS based on site of recurrence (intrahepatic: 16.9 months; extrahepatic: 16.6 months; intra- and extrahepatic: 16.2 month; P > 0.05). Receipt of adjuvant chemotherapy was associated with overall recurrence risk (hazard ratio [HR] = 0.56), while history of RFA (HR = 2.39, P = 0.001) and R1 margin status (HR = 1.36) were predictive of intrahepatic recurrence. Pattern of recurrence and RFS remained similar following repeat surgery for recurrent disease. CONCLUSIONS: While 5-year survival following surgery for colorectal liver metastasis approaches 50%, over one-half of patients develop recurrence within 2 years. The pattern of failure is distributed relatively equally among intrahepatic, extrahepatic, and intra- plus extrahepatic sites. Patients undergoing repeat surgery for recurrent metastasis have similar patterns of recurrence and RFS time.
Authors: Nancy E Kemeny; Joanne F Chou; Marinela Capanu; Alexandra N Gewirtz; Andrea Cercek; T Peter Kingham; William R Jarnagin; Yuman C Fong; Ronald P DeMatteo; Peter J Allen; Jinru Shia; Celina Ang; Efsevia Vakiani; Michael I D'Angelica Journal: Cancer Date: 2014-08-25 Impact factor: 6.860
Authors: Sadia Tasleem; Jarlath C Bolger; Michael E Kelly; Michael R Boland; Dermot Bowden; Karl J Sweeney; Carmel Malone Journal: Ir J Med Sci Date: 2018-02-01 Impact factor: 1.568
Authors: Yoshikuni Kawaguchi; Heather A Lillemoe; Elena Panettieri; Yun Shin Chun; Ching-Wei D Tzeng; Thomas A Aloia; Scott Kopetz; Jean-Nicolas Vauthey Journal: J Am Coll Surg Date: 2019-05-02 Impact factor: 6.113
Authors: E P van der Stok; M Smid; A M Sieuwerts; P B Vermeulen; S Sleijfer; N Ayez; D J Grünhagen; J W M Martens; C Verhoef Journal: Mol Oncol Date: 2016-09-20 Impact factor: 6.603
Authors: Omar Hyder; Ioannis Hatzaras; Georgios C Sotiropoulos; Andreas Paul; Sorin Alexandrescu; Hugo Marques; Carlo Pulitano; Eduardo Barroso; Bryan M Clary; Luca Aldrighetti; Cristina R Ferrone; Andrew X Zhu; Todd W Bauer; Dustin M Walters; Ryan Groeschl; T Clark Gamblin; J Wallis Marsh; Kevin T Nguyen; Ryan Turley; Irinel Popescu; Catherine Hubert; Stephanie Meyer; Michael A Choti; Jean-Francois Gigot; Gilles Mentha; Timothy M Pawlik Journal: Surgery Date: 2013-03-15 Impact factor: 3.982