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Prognostic Impact of Budding Grade in Patients With Residual Liver Recurrence of Colorectal Cancer After Initial Hepatectomy

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Many patients undergoing hepatectomy for colorectal liver metastases (CRLM) experience recurrence. However, no criteria for screening candidates to undergo repeat hepatectomy (RH) for CRLM have been established. Budding, one form by which colorectal carcinoma malignancies are expressed, is a new pathologic index. This study aimed to analyze prognostic factors, including budding, and to provide criteria for screening candidates to undergo RH for recurrent CRLM.

Methods

Data of 186 consecutive patients who underwent hepatectomy for CRLM between April 2008 and December 2015 were collected. Survival was calculated using the Kaplan–Meier method. Uni- and multivariate analyses were performed to determine factors significantly affecting mortality.

Results

Of 186 patients, 131 experienced recurrence after hepatectomy, with 83 of the 131 patients showing recurrence in the liver, and 52 of these 83 patients undergoing primary surgery at the authors’ institution and having information on budding grade. In the univariate analysis, preoperative chemotherapy, budding grade, extrahepatic metastases, and number of liver metastases at the time of recurrence were associated with overall survival (OS) for the 52 patients. In the multivariate analysis, budding grade and number of liver metastases at the time of recurrence were associated with OS.

Conclusion

The study examined simple prognostic factors that could help to screen patients better for RH. Repeat hepatectomy improved the prognosis for patients with recurrent CRLM. The independent prognostic factors for OS were number of liver metastases at recurrence as a conventional factor and budding grade as a new pathologic factor. With budding used as an index, patients who could benefit from hepatectomy can be screened more precisely.

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Acknowledgments

We thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Surgery, Dokkyo Medical University Saitama Medical Center, Koshigaya-Shi, Saitama, Japan

    Takuji Noro MD, PhD

  2. Department of Surgery, National Defense Medical College, Tokorozawa-Shi, Saitama, Japan

    Makoto Nishikawa MD, Takahiro Einama MD, PhD, Suefumi Aosasa MD, PhD, Yoshiki Kajiwara MD, PhD, Yoshihisa Yaguchi MD, PhD, Koichi Okamoto MD, PhD, Eiji Shinto MD, PhD, Hironori Tsujimoto MD, PhD, Kazuo Hase MD, PhD & Hideki Ueno MD, PhD

  3. Department of Surgery, New Tokyo Hospital, Matsudo-Shi, Chiba, Japan

    Mayumi Hoshikawa MD, PhD & Junji Yamamoto MD, PhD

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  1. Takuji Noro MD, PhD
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  2. Makoto Nishikawa MD
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  3. Mayumi Hoshikawa MD, PhD
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  4. Takahiro Einama MD, PhD
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  13. Junji Yamamoto MD, PhD
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Correspondence to Takuji Noro MD, PhD.

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Noro, T., Nishikawa, M., Hoshikawa, M. et al. Prognostic Impact of Budding Grade in Patients With Residual Liver Recurrence of Colorectal Cancer After Initial Hepatectomy. Ann Surg Oncol 27, 5200–5207 (2020). https://doi.org/10.1245/s10434-020-08684-3

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  • DOI: https://doi.org/10.1245/s10434-020-08684-3

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