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Risk factors for survival following recurrence after first liver resection for colorectal cancer liver metastases
Author(s) -
Serrano Pablo E.,
Gu ChuShu,
Husien Mohamed,
Jalink Diederick,
Ritter Anne,
Martel Guillaume,
Tsang Melanie E.,
Law Calvin H.,
Hallet Julie,
McAlister Vivian,
Sela Nathalie,
Solomon Hannah,
Moulton CarolAnne,
Gallinger Steven,
Levine Mark
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25735
Subject(s) - medicine , colorectal cancer , proportional hazards model , hazard ratio , hepatectomy , surgery , resection , survival analysis , gastroenterology , cancer , confidence interval
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.