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Effect on Outcome of Recurrence Patterns After Hepatectomy for Colorectal Metastases

Annals of Surgical Oncology volume 18, pages 1096–1103 (2011)Cite this article

Abstract

Background

Despite improvements in surgery and chemotherapy, most patients develop recurrence after hepatectomy for metastatic colorectal cancer. Data are lacking on the effect of these patterns on outcome.

Methods

A retrospective review of a prospectively maintained hepatobiliary database was performed. Pattern and timing of recurrence and outcome after recurrence were analyzed. Univariate and multivariate analyses of factors associated with outcome after recurrence were carried out.

Results

From January 1997 through May 2003, a total of 733 patients underwent hepatectomy for colorectal metastases. Of these, 637 patients (87%) were included in the analysis, and in 393 patients (62%), recurrence was documented at the time of last follow-up. Initial recurrence patterns included the following: liver only in 120 patients (31%), lung only in 107 (27%), other single sites in 49 (12%), and multiple sites in 117 (30%). Recurrence occurred within 2 years of hepatectomy in 75% of patients and after 3 years in 11%. Margins at hepatectomy, recurrence pattern, resected recurrence, and disease-free interval from time of colectomy to hepatic metastasis and from time of hepatectomy to recurrence were independently associated with survival as measured from the time of recurrence. Recurrence in the lung, resected recurrence, and time to recurrence after hepatectomy were associated with prolonged survival as measured from the time of hepatectomy and the time of recurrence.

Conclusions

The timing and pattern of recurrence after hepatic resection for metastatic colorectal cancer are important predictors of long-term survival.

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Author information

Affiliations

  1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Michael D’Angelica MD, FACS, Peter Kornprat MD, Ronald P. DeMatteo MD, FACS, Yuman Fong MD, FACS, Leslie H. Blumgart MD, FACS, FRCS & William R. Jarnagin MD, FACS

  2. Department Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Mithat Gonen PhD

Authors
  1. Michael D’Angelica MD, FACS
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  2. Peter Kornprat MD
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  3. Mithat Gonen PhD
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  4. Ronald P. DeMatteo MD, FACS
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  5. Yuman Fong MD, FACS
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  6. Leslie H. Blumgart MD, FACS, FRCS
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  7. William R. Jarnagin MD, FACS
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Corresponding author

Correspondence to Michael D’Angelica MD, FACS.

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D’Angelica, M., Kornprat, P., Gonen, M. et al. Effect on Outcome of Recurrence Patterns After Hepatectomy for Colorectal Metastases. Ann Surg Oncol 18, 1096–1103 (2011). https://doi.org/10.1245/s10434-010-1409-1

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  • DOI: https://doi.org/10.1245/s10434-010-1409-1

Keywords

  • Hepatic Resection
  • Recurrence Pattern
  • Colorectal Metastasis
  • Hepatic Arterial Infusion
  • Initial Recurrence