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Long-term survival in colorectal liver metastasis

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Abstract

Introduction

Liver resection is the best treatment option for patients with resectable colorectal liver metastasis (CRLM). A 10-year follow-up can reflect the true curative potential of resection. This retrospective study investigated factors for long-term survival of CRLM patients.

Method

Data of patients who underwent liver resection for CRLM without extrahepatic disease from 1990 to 2012 at our hospital were reviewed. Patients who survived for > 10 years were compared with those who survived for < 10 years.

Results

Totally, 315 patients were included in the study. They were divided into 2 groups: < 10-year group and > 10-year group. Patients in the < 10-year group had more tumor nodules (P = 0.016), more bilobar involvement (P = 0.004), narrower resection margin (P < 0.001), and worse disease-free and overall survival (P < 0.001). On multivariate analysis, low preoperative hemoglobin level, large number of tumor nodules, and bilobar involvement were poor prognostic factors for overall survival, while adjuvant chemotherapy was a favorable factor. Further analysis of patients with bilobar disease showed that perioperative blood transfusion was a poor prognostic factor for overall survival while adjuvant chemotherapy was a favorable one. In patients with multiple bilobar tumor nodules, adjuvant chemotherapy had a positive impact on disease-free survival and overall survival.

Conclusions

Patients who survived for > 10 years after liver resection for CRLM tended to have normal preoperative hemoglobin level, unilobar disease, fewer tumor nodules, and have received adjuvant chemotherapy. Adjuvant chemotherapy favorably affected long-term survival of CRLM patients.

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Authors and Affiliations

  1. Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China

    Wong Hoi She, Tan To Cheung, Simon H. Y. Tsang, Wing Chiu Dai, Albert C. Y. Chan & Chung Mau Lo

  2. Department of Clinical Oncology, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China

    Ka On Lam

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  1. Wong Hoi She
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She, W.H., Cheung, T.T., Tsang, S.H.Y. et al. Long-term survival in colorectal liver metastasis. Langenbecks Arch Surg 407, 3533–3541 (2022). https://doi.org/10.1007/s00423-022-02661-y

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