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Chance of Cure Following Liver Resection for Initially Unresectable Colorectal Metastases: Analysis of Actual 5-Year Survival

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Survival with long-term follow-up following liver resection for unresectable colorectal liver metastases (CRLM) downsized by chemotherapy has rarely been reported. The aim of this study was to determine the chance of cure following liver resection for initially unresectable CRLM.

Methods

Between January 2000 and December 2009, 61 patients underwent hepatectomy for unresectable liver-only CRLM downsized after chemotherapy. Cure was defined as a recurrence-free interval of at least 5 years after primary hepatectomy.

Results

Resectability of CRLM was achieved after a mean number of 11 courses, and 42.6 % of patients underwent liver resection after ≥10 courses. Postoperative mortality was nil, and morbidity rate was 19.7 %. The 5- and 10-year actuarial overall survival rates were 42.6 and 16.0 %. Of 30 patients with a follow-up ≥5 years, 11 were alive, yielding a 5-year actual overall survival rate of 36.7 %, and 7 (23.3 %) were considered cured because they are alive without recurrence. On multivariate analysis, response to chemotherapy was the only independent predictor of both overall and disease-free survival.

Conclusions

Cure can be achieved in about 23 % of patients resected for initially unresectable CRLM downsized by chemotherapy. Liver resection can be safely performed in selected patients even after multiple courses of chemotherapy.

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Acknowledgments

This study was supported by a contribution from “Centro Universitario Cattolico” and by the Catholic University and the Italian Ministry for Instruction, University and Research (D.1. Funds).

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Authors and Affiliations

  1. Department of Surgery, Hepatobiliary Surgery Unit, Catholic University of the Sacred Heart, School of Medicine, L.go A. Gemelli, 8, 00168, Rome, Italy

    Francesco Ardito, Maria Vellone, Agostino M. De Rose, Alessandro Coppola, Ivo Giovannini, Gennaro Nuzzo & Felice Giuliante

  2. Division of Medical Oncology, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy

    Alessandra Cassano, Carmelo Pozzo & Carlo Barone

  3. Department of Health and Sport Sciences, University of Cassino, Cassino, FR, Italy

    Bruno Federico

Authors
  1. Francesco Ardito
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  2. Maria Vellone
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  3. Alessandra Cassano
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  4. Agostino M. De Rose
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  5. Carmelo Pozzo
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  6. Alessandro Coppola
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  7. Bruno Federico
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  8. Ivo Giovannini
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  9. Carlo Barone
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  10. Gennaro Nuzzo
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  11. Felice Giuliante
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Correspondence to Francesco Ardito.

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Ardito, F., Vellone, M., Cassano, A. et al. Chance of Cure Following Liver Resection for Initially Unresectable Colorectal Metastases: Analysis of Actual 5-Year Survival. J Gastrointest Surg 17, 352–359 (2013). https://doi.org/10.1007/s11605-012-2103-3

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  • DOI: https://doi.org/10.1007/s11605-012-2103-3

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