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

Carlo Pulitanó, Federico Castillo, Luca Aldrighetti, Martin Bodingbauer, Rowan W. Parks, Gianfranco Ferla, Stephen J. Wigmore, O. James Garden

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)244-249
Number of pages6
JournalHPB
Volume12
Issue number4
DOIs
Publication statusPublished - 2010

Fingerprint

Neoplasm Metastasis
Liver
Survival Rate
Recurrence
Survivors
Multivariate Analysis
Standard of Care
Neoplasms
Databases
Survival

Keywords

  • Colorectal cancer
  • Disease-free survival
  • Liver metastasis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

Cite this

Pulitanó, C., Castillo, F., Aldrighetti, L., Bodingbauer, M., Parks, R. W., Ferla, G., ... Garden, O. J. (2010). What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up. HPB, 12(4), 244-249. https://doi.org/10.1111/j.1477-2574.2010.00155.x

What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up. / Pulitanó, Carlo; Castillo, Federico; Aldrighetti, Luca; Bodingbauer, Martin; Parks, Rowan W.; Ferla, Gianfranco; Wigmore, Stephen J.; Garden, O. James.

In: HPB, Vol. 12, No. 4, 2010, p. 244-249.

Research output: Contribution to journalArticle

Pulitanó, C, Castillo, F, Aldrighetti, L, Bodingbauer, M, Parks, RW, Ferla, G, Wigmore, SJ & Garden, OJ 2010, 'What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up', HPB, vol. 12, no. 4, pp. 244-249. https://doi.org/10.1111/j.1477-2574.2010.00155.x
Pulitanó, Carlo ; Castillo, Federico ; Aldrighetti, Luca ; Bodingbauer, Martin ; Parks, Rowan W. ; Ferla, Gianfranco ; Wigmore, Stephen J. ; Garden, O. James. / What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up. In: HPB. 2010 ; Vol. 12, No. 4. pp. 244-249.
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AU - Pulitanó, Carlo

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AU - Parks, Rowan W.

AU - Ferla, Gianfranco

AU - Wigmore, Stephen J.

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AB - 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.

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