Skip to main content
SpringerLink
Log in

Predictors and outcome of early recurrence after resection of hepatic metastases from colorectal cancer

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to investigate the risk factors for early recurrence in patients who had undergone curative resection of colorectal liver metastases (CRLM) and to evaluate the outcome after recurrence.

Methods

A total of 119 patients were divided into 2 groups: an early recurrence group (n = 54) who had recurrence within 2 years of curative resection of CRLM and a 2-year recurrence-free group (n = 65) who remained disease-free for at least 2 years following surgery.

Results

During the initial 5-year period after surgery, 4 out of 65 patients (6%) in the 2-year recurrence-free group and 29 out of 54 patients (54%) in the early recurrence group died. Multivariate analysis showed that postoperative morbidity was an independent predictor of early recurrence after curative resection of CRLM.

Conclusions

Early recurrence is the leading cause of death within 5 years after curative resection of CRLM. Postoperative morbidity increases the risk of early recurrence in these patients. A reduction in perioperative morbidity may, therefore, improve the outcome of curative resection, as well as reducing medical costs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Choti MA, Sitzmann IV, Iiburi MF et al (2002) Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg 235:759–766

    Article  PubMed  Google Scholar 

  2. Rees M, Plant G, Bygrave S (1997) Late results justify resection for multiple hepatic metastases from colorectal cancer. Br J Surg 84:1136–1140

    Article  PubMed  CAS  Google Scholar 

  3. Sugihara K, Hojo K, Moriya Y et al (1993) Pattern of recurrence after hepatic resection for colorectal metastases. Br J Surg 80:1032–1035

    Article  PubMed  CAS  Google Scholar 

  4. Ohlsson B, Stenram U, Iranberg KG et al (1998) Resection of colorectal liver metastases: 25-year experience. World J Surg 22:268–276

    Article  PubMed  CAS  Google Scholar 

  5. Scheele I, Stangl R, Altendorf-Hofmann A et al (1991) Indication of prognosis after hepatic resection for colorectal secondaries. Surgery 110:13–29

    PubMed  CAS  Google Scholar 

  6. Abdalla EK, Vauthey JN, Ellis LM et al (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239:818–825

    Article  PubMed  Google Scholar 

  7. Pawlik TM, Scoggins CR, Zorzi D et al (2005) Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg 241:715–722

    Article  PubMed  Google Scholar 

  8. Nordlinger B, Guiguet M, Vaillant JC et al (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 77:1254–1262

    Article  PubMed  CAS  Google Scholar 

  9. Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–946

    PubMed  CAS  Google Scholar 

  10. Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318

    Article  PubMed  CAS  Google Scholar 

  11. Kurtz JM, Amalric R, Brandone H et al (1989) Local recurrence after breast-conserving surgery and radiotherapy. Frequency, time course, and prognosis. Cancer 63:1912–1917

    Article  PubMed  CAS  Google Scholar 

  12. Minagawa M, Makuuchi M, Takayama T et al (2003) Selection criteria for repeat hepatectomy in patients with recurrent hepatocellular carcinoma. Ann Surg 238:703–710

    Article  PubMed  Google Scholar 

  13. Schrodter S, Hakenberg OW, Manseck A et al (2002) Outcome of surgical treatment of isolated local recurrence after radical nephrectomy for renal cell carcinoma. J Urol 167:1630–1633

    Article  PubMed  Google Scholar 

  14. Minagawa M, Makuuchi M, Torzilli G et al (2000) Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 231:487–499

    Article  PubMed  CAS  Google Scholar 

  15. Adam R, Pascal G, Azoulay D et al (2003) Liver resection for colorectal metastases: the third hepatectomy. Ann Surg 238:871–883

    Article  PubMed  Google Scholar 

  16. Ueno H, Mochizuki H, Hatsuse K et al (2000) Indications for treatment strategies of colorectal liver metastases. Ann Surg 231:59–66

    Article  PubMed  CAS  Google Scholar 

  17. Lise M, Bacchetti S, Da Pian P et al (2001) Patterns of recurrence after resection of colorectal liver metastases: prediction by models of outcome analysis. World J Surg 25:638–644

    Article  PubMed  CAS  Google Scholar 

  18. Schindl M, Wigmore SJ, Currie EJ et al (2005) Prognostic scoring in colorectal cancer liver metastases. Arch Surg 140:183–189

    Article  PubMed  Google Scholar 

  19. Mutsaerts EI, van Ruth S, Zoetmulder FA et al (2005) Prognostic factors and evaluation of surgical management of hepatic metastases from colorectal origin: a 10-year single-institute experience. J Gastrointest Surg 9:178–186

    Article  PubMed  Google Scholar 

  20. Strasberg SM, Belghiti J, Clavn P-A et al (2000) The Brisbane 2000 terminology of liver anatomy and resection. Terminology Committee of the International Hepato-Pancreato-Biliary Association. HPB 2:333–339

    Google Scholar 

  21. Couinaud C (1957) Les hepatectomies elargies. In: Couinaud C (ed) Le Foie: Etudes Anatomiques et Chirurgicales. Masson, Paris, pp 400–409

    Google Scholar 

  22. Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications—five-year experience. Ann Surg 250:187–196

    Article  PubMed  Google Scholar 

  23. Scheele J, Stangl R, Altendorf-Hofmann A et al (1995) Resection of colorectal liver metastases. World J Surg 19:59–71

    Article  PubMed  CAS  Google Scholar 

  24. Ambiru S, Miyazaki M, Isono T et al (1999) Hepatic resection for colorectal metastases: analysis of prognostic factors. Dis Colon Rectum 42:632–639

    Article  PubMed  CAS  Google Scholar 

  25. Harms J, Obst T, Thorban S et al (1999) The role of surgery in the treatment of liver metastases for colorectal cancer patients. Hepatogastroenterology 46:2321–2328

    PubMed  CAS  Google Scholar 

  26. Figueras J, Valls C, Rafecas A et al (2001) Resection rate and effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br J Surg 88:980–985

    Article  PubMed  CAS  Google Scholar 

  27. Chok KS, Ng KK, Poon RT et al (2009) Impact of postoperative complications on long-term outcome of curative resection for hepatocellular carcinoma. Br J Surg 96:81–87

    Article  PubMed  CAS  Google Scholar 

  28. Dimick JB, Pronovost PJ, Cowan JA et al (2003) Complications and costs after high-risk surgery: where should we focus quality improvement initiatives? J Am Coll Surg 196:671–678

    Article  PubMed  Google Scholar 

  29. Khuri SF, Henderson WG, DePalma RG et al (2005) Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 242:326–341, discussion 341–343

    PubMed  Google Scholar 

  30. de Melo GM, Ribeiro KC, Kowalski LP et al (2001) Risk factors for postoperative complications in oral cancer and their prognostic implications. Arch Otolaryngol Head Neck Surg 127:828–833

    PubMed  Google Scholar 

  31. McArdle CS, McMillan DC, Hole DJ et al (2005) Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer. Br J Surg 92:1150–1154

    Article  PubMed  CAS  Google Scholar 

  32. Law WL, Choi HK, Lee YM et al (2007) The impact of postoperative complications on long-term outcomes following curative resection for colorectal cancer. Ann Surg Oncol 14:2559–2566

    Article  PubMed  Google Scholar 

  33. Rizk NP, Bach PB, Schrag D et al (2004) The impact of complications on outcomes after resection for esophageal and gastroesophageal junction carcinoma. J Am Coll Surg 198:42–50

    Article  PubMed  Google Scholar 

  34. Vigano L, Ferrero A, Tesoriere RL et al (2008) Liver surgery for colorectal metastases: results after 10 years of follow-up. Long-term survivors, late recurrences, and prognostic role of morbidity. Ann Surg Oncol 15:2458–2464

    Article  PubMed  Google Scholar 

  35. Ito H, Chandrakanth A, Gonen M et al (2008) Effect of postoperative morbidity on long-term survival after hepatic resection for metastatic colorectal cancer. Ann Surg 247:994–1002

    Article  PubMed  Google Scholar 

  36. Farid SG, Aldouri A, Morris-Stiff G et al (2010) Correlation between postoperative infective complications and long-term outcomes after hepatic resection for colorectal liver metastasis. Ann Surg 251:91–100

    Article  PubMed  Google Scholar 

  37. Laurent C, Cunha AS, Couderc P et al (2003) Influence of postoperative morbidity on long-term survival following liver resection for colorectal metastases. Br J Surg 90:1131–1136

    Article  PubMed  CAS  Google Scholar 

  38. Lundy J, Ford CM (1983) Surgery, trauma and immune suppression. Evolving the mechanism. Ann Surg 197:434–438

    Article  PubMed  CAS  Google Scholar 

  39. Hirai T, Yamashita Y, Mukaida H et al (1998) Poor prognosis in esophageal cancer patients with postoperative complications. Surg Today 28:576–579

    Article  PubMed  CAS  Google Scholar 

  40. Petersen S, Freitag M, Hellmich G et al (1998) Anastomotic leakage: impact on local recurrence and survival in surgery of colorectal cancer. Int J Colorectal Dis 13:160–163

    Article  PubMed  CAS  Google Scholar 

  41. Mynster T, Christensen IJ, Moesgaard F et al (2000) Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANXOS Colorectal Cancer Study Group. Br J Surg 87:1553–1562

    Article  PubMed  CAS  Google Scholar 

  42. Nordlinger B, Sorbye H, Glimelius B et al (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 371:1007–1016

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan

    Masaki Kaibori, Yoshinori Iwamoto, Morihiko Ishizaki, Kosuke Matsui, Kazuhiko Yoshioka & A-Hon Kwon

  2. School of Nursing, Kyoto Prefectural University of Medicine, Kyoto, 602-0857, Japan

    Hiroaki Asano

Authors
  1. Masaki Kaibori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshinori Iwamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Morihiko Ishizaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kosuke Matsui
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazuhiko Yoshioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroaki Asano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A-Hon Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masaki Kaibori.

Additional information

Synopsis for table of contents

Early recurrence is the leading cause of death within 5 years after curative resection of liver metastases from colorectal cancer. Postoperative morbidity influences early recurrence in patients with colorectal liver metastases.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaibori, M., Iwamoto, Y., Ishizaki, M. et al. Predictors and outcome of early recurrence after resection of hepatic metastases from colorectal cancer. Langenbecks Arch Surg 397, 373–381 (2012). https://doi.org/10.1007/s00423-011-0861-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-011-0861-0

Keywords

Search

Navigation