Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis Professional Medicine

Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis

September 25, 2010, 10:28 pm

Abstract (provisional)

Background

Hepatectomy is recommended as the best effective therapy for liver metastasis from colorectal cancer (CRCLM). It is crucial to elucidate the prognostic clinicopathological factors.

Methods

Eighty-three patients undergoing initial hepatectomy for CRCLM were retrospectively analyzed with respect to tumor characteristics of primary colorectal and metastatic hepatic tumors, operation details and prognosis.

Results

The overall 5-year survival rate after initial hepatectomy for CRCLM was 57.5%, and the median survival time was 25 months. Univariate analysis clarified that the significant prognostic factors for poor survival were the depth of primary colorectal cancer (> serosal invasion), hepatic resection margin (< 5 mm), presence of portal vein invasion of CRCLM, and the presence of intra- and extrahepatic recurrence. Multivariate analysis indicated the presence of intra- and extrahepatic recurrence as the independent predictive factors for poor prognosis. The risk factors for intrahepatic recurrence were resection margin (< 5 mm) of CRCLM, while no risk factor for extrahepatic recurrence was noted. In subgroup with synchronous CRCLM, combination of surgery and adjuvant chemotherapy controlled intrahepatic recurrence and improve the prognosis significantly.

Conclusions

Optimal surgical strategies in conjunction with effective chemotherapeutic regimens need to be established in patients with risk factors for recurrence and poor outcome listed above.

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