Solitary colorectal liver metastasis after curative intent surgery: prognostic factors affecting outcomes and survival.


Journal

ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634

Informations de publication

Date de publication:
01 2019
Historique:
received: 24 05 2018
revised: 16 09 2018
accepted: 02 10 2018
pubmed: 30 11 2018
medline: 3 4 2020
entrez: 29 11 2018
Statut: ppublish

Résumé

The aim of this study was to identify the prognostic factors affecting recurrence and survival in patients who underwent curative intent surgery for colorectal cancer (CRC) with a single liver metastasis. Between January 2006 and August 2012, we retrospectively evaluated 141 patients for CRC with single liver metastasis underwent curative intent surgery for colon and liver simultaneously. Some patients (11.3%) had radiofrequency ablation as an option. The 5-year disease-free and overall survival (OS) rates were 38.9% and 59.6%, respectively. Recurrence occurred in 77 (54.6%) patients after surgery. Multivariate analysis identified node positivity and no adjuvant chemotherapy as independent risk factors for OS. We analyzed the OS risk factors in 76 recurred patients from the time of recurrence. Multivariate analysis revealed the following significant risk factors for OS after recurrence: a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis. Patients who underwent a curative resection for CRC with a single liver metastasis had a relatively favourable prognosis; in these patients, node positivity and no adjuvant chemotherapy were independent prognostic factors for OS. Furthermore, a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis may be independent prognostic factors for OS in patients with recurrence. The left hepatic metastasis group tended to have a multiple hepatic relapse more frequently than the right hepatic metastasis group in cases of isolated hepatic relapse.

Sections du résumé

BACKGROUND
The aim of this study was to identify the prognostic factors affecting recurrence and survival in patients who underwent curative intent surgery for colorectal cancer (CRC) with a single liver metastasis.
METHODS
Between January 2006 and August 2012, we retrospectively evaluated 141 patients for CRC with single liver metastasis underwent curative intent surgery for colon and liver simultaneously. Some patients (11.3%) had radiofrequency ablation as an option.
RESULTS
The 5-year disease-free and overall survival (OS) rates were 38.9% and 59.6%, respectively. Recurrence occurred in 77 (54.6%) patients after surgery. Multivariate analysis identified node positivity and no adjuvant chemotherapy as independent risk factors for OS. We analyzed the OS risk factors in 76 recurred patients from the time of recurrence. Multivariate analysis revealed the following significant risk factors for OS after recurrence: a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis.
CONCLUSION
Patients who underwent a curative resection for CRC with a single liver metastasis had a relatively favourable prognosis; in these patients, node positivity and no adjuvant chemotherapy were independent prognostic factors for OS. Furthermore, a high serum carcinoembryonic antigen concentration at the time of recurrence, the treatment type after recurrence (chemotherapy or no treatment) and a left hepatic metastasis may be independent prognostic factors for OS in patients with recurrence. The left hepatic metastasis group tended to have a multiple hepatic relapse more frequently than the right hepatic metastasis group in cases of isolated hepatic relapse.

Identifiants

pubmed: 30484933
doi: 10.1111/ans.14933
doi:

Substances chimiques

Carcinoembryonic Antigen 0

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

61-67

Informations de copyright

© 2018 Royal Australasian College of Surgeons.

Auteurs

Heeji Shin (H)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Chan Wook Kim (CW)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Jong Lyul Lee (JL)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Yong Sik Yoon (YS)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

In Ja Park (IJ)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Seok-Byung Lim (SB)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Chang Sik Yu (CS)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

Jin Cheon Kim (JC)

Department of Surgery, University of Ulsan College of Medicine, Institute of Innovative Cancer Research, and Asan Medical Center, Seoul, South Korea.

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