Risk factors for survival following recurrence after first liver resection for colorectal cancer liver metastases Academic Article uri icon

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abstract

  • BACKGROUND: Management of recurrence following liver resection for colorectal cancer metastases is a topic of debate. We determined risk factors for survival following recurrence after liver resection. METHODS: Long-term follow-up of patients in the PETCAM trial who had recurrence following liver resection. Risk groups were created according to their survival risk. Differences in overall survival (OS) between groups were estimated. Disease-free survival (DFS), patterns of disease recurrence and management were determined. Cox proportional hazard models, Kaplan-Meier method, and the log-rank test were used. RESULTS: Among 368 patients who underwent liver resection, 264 (72%) experienced disease recurrence (51% lung and 41% liver). Following liver resection, DFS: 17 months (95% CI, 14-19); OS: 57 months (95% CI, 46-70). In those who recurred, 120 (45%) received chemotherapy only, and 112 (42%) underwent second surgical resection. Among patients who experienced recurrence (n = 264), the high-risk group (more than one site of recurrence or disease-free duration < 5 months and node-positive disease) had median OS: 19 months (95% CI, 15-23) vs 36 months (95% CI, 30-48) for patients in the low-risk group (HR = 2.9, 95% CI, 2.2-3.9). CONCLUSION: Recurrence following liver resection is common. Following recurrence after liver resection, patients should be carefully selected for surgical re-resection based on risk factors.

authors

  • Serrano Aybar, Pablo
  • Serrano, Pablo E
  • Gu, Chu‐Shu
  • Husien, Mohamed
  • Jalink, Diederick
  • Ritter, Anne
  • Martel, Guillaume
  • Tsang, Melanie E
  • Law, Calvin H
  • Hallet, Julie
  • McAlister, Vivian
  • Sela, Nathalie
  • Solomon, Hannah
  • Moulton, Carol‐Anne
  • Gallinger, Steven
  • Levine, Mark

publication date

  • December 2019

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