Risk factors for survival following recurrence after first liver resection for colorectal cancer liver metastases. Issue 8 (14th October 2019)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Journal of surgical oncology. Volume 120:Issue 8(2019)
• Page Start: 1420
• Page End: 1426
• Publication Date: 2019-10-14
• Subjects: colon cancer -- liver metastases -- PET‐CT -- recurrence; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25735
• Languages: English
• ISSNs: 0022-4790

Abstract

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.