Masaru Oba1, Kiyoshi Hasegawa1, Junichi Shindoh1, Suguru Yamashita1, Yoshihiro Sakamoto1, Masatoshi Makuuchi2, Norihiro Kokudo3. 1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 2. Department of Hepato-Biliary-Pancreatic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan. 3. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kokudo-2su@h.u-tokyo.ac.jp.
Abstract
BACKGROUND: Relapse is common after the resection of colorectal liver metastases (CLM); however, the optimal treatment for such recurrent disease remains uncertain. We investigated whether repeat resections for successive recurrences of CLM provide survival benefit on the postrecurrence survival. METHODS: We reviewed patients who underwent upfront, curative resection for CLM at our center during a 15-year period. Of these, 263 patients who had not received any other perioperative treatment for the metastases were eligible for our analysis. The recurrence-free survival (RFS0) after the initial hepatic resection and after the first (n = 108), second (n = 43), and third (n = 15) repeat resections for recurrent disease were assessed (RFS1-3). The overall survival after the initial hepatic resection and the postrecurrence survival (n = 198) also was assessed. RESULTS: The median RFS0 was 0.8 years, and RFS1, RFS2, and RFS3 were 1.3, 1.1, and 2.0 years, respectively. The hazard ratio for RFS for the first, second, and third resections versus the initial hepatic resection was 0.9 (95% confidence interval [95% CI] 0.7-1.1; P = .34), 1.00 (95% CI 0.7-1.4; P = .97), and 0.7 (95% CI 0.4-1.3; P = .29). The 5-year and 10-year OS rates were 54.6% and 42.2%, and the 5-year and 10-year postrecurrence survival was 34.3% and 28.6%, respectively. CONCLUSION: Repeat resection in patients with recurrent disease after CLM resection is beneficial, offering the potential for cure in a small proportion of patients with recurrent disease.
BACKGROUND: Relapse is common after the resection of colorectal liver metastases (CLM); however, the optimal treatment for such recurrent disease remains uncertain. We investigated whether repeat resections for successive recurrences of CLM provide survival benefit on the postrecurrence survival. METHODS: We reviewed patients who underwent upfront, curative resection for CLM at our center during a 15-year period. Of these, 263 patients who had not received any other perioperative treatment for the metastases were eligible for our analysis. The recurrence-free survival (RFS0) after the initial hepatic resection and after the first (n = 108), second (n = 43), and third (n = 15) repeat resections for recurrent disease were assessed (RFS1-3). The overall survival after the initial hepatic resection and the postrecurrence survival (n = 198) also was assessed. RESULTS: The median RFS0 was 0.8 years, and RFS1, RFS2, and RFS3 were 1.3, 1.1, and 2.0 years, respectively. The hazard ratio for RFS for the first, second, and third resections versus the initial hepatic resection was 0.9 (95% confidence interval [95% CI] 0.7-1.1; P = .34), 1.00 (95% CI 0.7-1.4; P = .97), and 0.7 (95% CI 0.4-1.3; P = .29). The 5-year and 10-year OS rates were 54.6% and 42.2%, and the 5-year and 10-year postrecurrence survival was 34.3% and 28.6%, respectively. CONCLUSION: Repeat resection in patients with recurrent disease after CLM resection is beneficial, offering the potential for cure in a small proportion of patients with recurrent disease.
Authors: Dimitrios Moris; Sean Ronnekleiv-Kelly; Amir A Rahnemai-Azar; Evangelos Felekouras; Mary Dillhoff; Carl Schmidt; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-03-31 Impact factor: 3.452
Authors: Boris Galjart; Eric P van der Stok; Joost Rothbarth; Dirk J Grünhagen; Cornelis Verhoef Journal: Ann Surg Oncol Date: 2016-07-08 Impact factor: 5.344