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Survival outcome of re‐resection for recurrent liver metastases of colorectal cancer: a retrospective study
Author(s) -
Chok Kenneth S. H.,
Cheung Tan To,
Chan Albert C. Y.,
Dai Wing Chiu,
Chan See Ching,
Fan Sheung Tat,
Poon Ronnie T. P.,
Lo Chung Mau
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12298
Subject(s) - medicine , colorectal cancer , hepatectomy , hazard ratio , resection margin , metastasis , confidence interval , univariate analysis , retrospective cohort study , proportional hazards model , surgery , gastroenterology , relative risk , multivariate analysis , cancer , resection
Background This study aimed to investigate whether re‐resection can achieve a good survival outcome in the treatment of recurrent liver metastases of colorectal cancer. Methods Prospectively collected data of patients who underwent hepatectomy for liver tumours were reviewed. Patients whose liver tumours were metastases of colorectal cancer were included in the study provided that they had no extrahepatic metastases and received no loco‐ablative treatment simultaneous with hepatectomy. Patients who did not have recurrent liver metastasis after their first liver resection (group R ) and patients who underwent re‐resection for recurrent liver metastasis (group RR ) were compared. Results In total, 321 patients were included in the study, with 307 in group R and 14 in group RR . The two groups had comparable demographics. Insignificantly more patients in group R received major resection (55.6% versus 30.8%, P = 0.079). The median blood loss volume was 0.6 (0–12.7) L in group R and 0.35 (0–15) L in group RR ( P = 0.202). Group RR had a significantly smaller median tumour size (2.5 cm versus 3.5 cm, P = 0.020) and resection margin width (0.3 cm versus 0.7 cm, P = 0.037). On univariate analysis, re‐resection was not a risk factor in overall survival. On multivariate analysis, post‐operative complication (hazard ratio ( HR) 1.66, 95% confidence interval ( CI) 1.15–2.39, P = 0.007), microscopic margin involvement ( HR 1.95, 95% CI 1.26–3.04, P = 0.003) and multiple tumours ( HR 1.58, 95% CI 1.17–2.14, P = 0.003) were risk factors in overall survival. The two groups had no significant differences in disease‐free survival and overall survival. Conclusion Re‐resection for recurrent colorectal liver metastases can achieve a favourable survival outcome at centres with expertise.