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Metastatic Tumor Doubling Time: Most Important Prehepatectomy Predictor of Survival and Nonrecurrence of Hepatic Colorectal Cancer Metastasis

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Abstract

We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection (n = 144) for colorectal cancer liver metastases were studied retrospectively to identify factors that influence overall survival and recurrence in the remnant liver. Overall 5-year survival and nonrecurrence rates were 49.8% and 50.8%, respectively. By multivariate analysis, large liver tumors (p = 0.038), p53 expression by the liver tumor (p = 0.011), and a short liver metastasis doubling time (≤ 45 days, p = 0.013) negatively affected survival; doubling times > 45 days (adjusted relative risk 0.06; p < 0.001) positively influenced disease-free survival. In patients with remnant liver recurrence, a short doubling time was associated with short disease-free intervals (7.3 ± 6.2 months), multiple metastases (63.6%), and fewer attempts at repeat hepatectomy (22.7%). The doubling time determines tumor size and reflects the patient’s immune and nutritional status. A short doubling time is the most reliable risk factor for multiple metastases, early recurrence, and poor prognosis. Further studies with a larger number of patients are needed to confirm this conclusion.

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Authors and Affiliations

  1. Department of Surgery II, Yokohama City University School of Medicine, 4-57 Urafune-cho, Minami-ku, 232-0024, Yokohama, Japan

    Kuniya Tanaka M.D., Ph.D., Hiroshi Shimada M.D., Ph.D., Masaru Miura M.D., Yoshiro Fujii M.D., Shigeki Yamaguchi M.D., Ph.D., Itaru Endo M.D., Hitoshi Sekido M.D., Ph.D., Shinji Togo M.D., Ph.D. & Hideyuki Ike M.D., Ph.D.

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  1. Kuniya Tanaka M.D., Ph.D.
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  2. Hiroshi Shimada M.D., Ph.D.
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  3. Masaru Miura M.D.
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  4. Yoshiro Fujii M.D.
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  5. Shigeki Yamaguchi M.D., Ph.D.
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  6. Itaru Endo M.D.
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  7. Hitoshi Sekido M.D., Ph.D.
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  8. Shinji Togo M.D., Ph.D.
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  9. Hideyuki Ike M.D., Ph.D.
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Tanaka, K., Shimada, H., Miura, M. et al. Metastatic Tumor Doubling Time: Most Important Prehepatectomy Predictor of Survival and Nonrecurrence of Hepatic Colorectal Cancer Metastasis. World J. Surg. 28, 263–270 (2004). https://doi.org/10.1007/s00268-003-7088-3

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