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Survival by Number and Sites of Resections of Recurrence after First Curative Resection of Colorectal Liver Metastases

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Recurrence after curative hepatectomy for colorectal liver metastases (CRLM) is common. We sought to determine if number and sites of resections of recurrence after hepatectomy for CRLM impact survival.

Methods

The study included patients who underwent resection of recurrence following complete curative-intent resection of CRLM during 1998–2016 at two academic medical centers in Houston, USA, and Rome, Italy. The survival impacts of number and sites of resections of recurrence were evaluated. Patients with synchronous extrahepatic disease at curative CRLM resection were excluded.

Results

Among 2163 patients who underwent curative hepatectomy, 1456 (67.3%) developed a recurrence. Four hundred seventy-eight patients underwent one (322/478; 67.4%) or two or more (156/478; 32.6%) resections of recurrence. The 5-year overall survival (OS) rate was higher in patients with resected than unresected recurrence (70.2% vs. 24.0%; p < 0.001). In patients who underwent only one resection of recurrence, the 5-year OS rate differed by location (lung, 81.6%; liver, 64.3%; other, 54.1%). In patients who underwent two or more resections of recurrence, the 5-year OS rate was similar for liver-only resection (87.5%) and resection of liver and other sites (66.1%) (p = 0.223) and for liver-only resection and other-sites-only resection (80.7%) (p = 0.258); 5-year OS rate by site of first resection of recurrence did not differ between liver (78.5%) and lung (81.8%) (p = 0.502) but was worse for other sites (61.1%) than for lung (p = 0.045).

Conclusion

When recurrence after initial CRLM resection is resectable, the ability to undergo resection was associated with improved survival and can be considered as an option regardless of the number of recurrence and resection. Sites of resection of recurrence impact survival and should be considered.

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Acknowledgements

The authors thank Dr. Yujiro Nishioka and Dr. Francesco Razionale for reviewing the data used in the study, Ms. Stephanie Deming, Senior Scientific Editor at MD Anderson Cancer Center, for copyediting the manuscript, and Ms. Ruth Haynes for administrative support in the preparation of this article.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA

    Elena Panettieri, Bradford J. Kim, Yoshikuni Kawaguchi, Yun Shin Chun, Ching-Wei D. Tzeng, Thomas A. Aloia & Jean-Nicolas Vauthey

  2. Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, 00168, Italy

    Elena Panettieri, Francesco Ardito, Caterina Mele, Agostino Maria De Rose, Maria Vellone & Felice Giuliante

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  1. Elena Panettieri
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Contributions

EP contributed to the conception/design of the work; EP, YK, JV contributed to the acquisition, analysis, or interpretation of the data; EP and BK drafted the manuscript; all authors critically revised the manuscript for intellectual content; and all authors approved the final version submitted and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Jean-Nicolas Vauthey.

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Meeting presentation: Oral presentation, 14th IHPBA World Congress. Virtual Congress, 27–29 November 2020.

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Panettieri, E., Kim, B.J., Kawaguchi, Y. et al. Survival by Number and Sites of Resections of Recurrence after First Curative Resection of Colorectal Liver Metastases. J Gastrointest Surg 26, 2503–2511 (2022). https://doi.org/10.1007/s11605-022-05456-0

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