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What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up

Title: What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up
Authors: Pulitano C; Castillo F; Aldrighetti L; Bodingbauer M; Parks RW; Ferla G; Wigmore SJ; Garden OJ
Contributors: Pulitano, C; Castillo, F; Aldrighetti, L; Bodingbauer, M; Parks, Rw; Ferla, G; Wigmore, Sj; Garden, Oj
Publication Year: 2010
Description: Background: During the last two decades, resection of colorectal liver metastases (CLM) in selected patients has become the standard of care, with 5-year survival rates of 25-58%. Although a substantial number of actual 5-year survivors are reported after resection, 5-year survival rates may be inadequate to evaluate surgical outcomes because a significant number of patients experience a recurrence at some point. Objectives: This study aimed to analyse longterm results and prognostic factors in liver resection for CLM in patients with complete 10-year follow-up data. Methods: A total of 369 patients who underwent liver resection for CLM between 1985 and 1998 were identified from a bi-institutional database. Postoperative deaths and patients with extrahepatic disease were excluded. Clinicopathological prognostic factors were analysed using univariate and multivariate analyses. Results: The sample included 309 consecutive patients with complete 10-year follow-up data. Five-and 10-year overall survival rates were 32% and 23%, respectively. Overall, 93% of recurrences occurred within the first 5 years of follow-up, but 11% of patients who were disease-free at 5 years developed later recurrence. Multivariate analysis demonstrated four independent negative prognostic factors for survival: more than three metastases; a positive surgical margin; tumour size >5 cm, and a clinical risk score >2. Conclusions: Five-year survival rates are not adequate to evaluate surgical outcomes of patients with CLM. Approximately one-third of actual 5-year survivors suffer cancer-related death, whereas patients who survive 10 years appear to be cured of disease.
Document Type: article in journal/newspaper
Language: unknown
Relation: info:eu-repo/semantics/altIdentifier/wos/WOS:000286436100003; volume:12; issue:4; firstpage:244; lastpage:249; numberofpages:6; journal:HPB; https://hdl.handle.net/20.500.11768/93779
DOI: 10.1111/j.1477-2574.2010.00155.x
Availability: https://hdl.handle.net/20.500.11768/93779; https://doi.org/10.1111/j.1477-2574.2010.00155.x
Accession Number: edsbas.DA4155FF
Database: BASE