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Predictors of early recurrence after resection of colorectal liver metastases.

Bhogal RH, Hodson J, Bramhall SR, Isaac J, Marudanayagam R, Mirza DF, Muiesan P, Sutcliffe RP - World J Surg Oncol (2015)

Bottom Line: Dukes C stage and male sex were significantly associated with early liver-only recurrence (P < 0.05).Tumour size ≥3.6 cm and tumour number (>2) were significantly associated with early systemic recurrence (P < 0.001).High-risk patients may be candidates for preoperative MRI and/or computed tomography-positron emission tomography (CT-PET) scan and should receive intensive postoperative surveillance.

View Article: PubMed Central - PubMed

Affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. balsin@hotmail.com.

ABSTRACT

Background: Early recurrence after resection of colorectal liver metastases (CLM) is common. Patients at risk of early recurrence may be candidates for enhanced preoperative staging and/or earlier postoperative imaging. The aim of this study was to determine if there are any risk factors that specifically predict early liver-only and systemic recurrence.

Methods: Retrospective analysis of prospective database of patients undergoing liver resection (LR) for CLM from 2004 to 2006 was undertaken. Early recurrence was defined as occurring within 18 months of LR. Patients were classified into three groups: early liver-only recurrence, early systemic recurrence and recurrence-free. Preoperative factors were compared between patients with and without early recurrence.

Results: Two hundred and forty-three consecutive patients underwent LR for CLM. Twenty-seven patients (11%) developed early liver-only recurrence. Dukes C stage and male sex were significantly associated with early liver-only recurrence (P < 0.05). Sixty-six patients (27%) developed early systemic recurrence. Tumour size ≥3.6 cm and tumour number (>2) were significantly associated with early systemic recurrence (P < 0.001).

Conclusions: It is possible to stratify patients according to the risk of early liver-only or systemic recurrence after resection of CLM. High-risk patients may be candidates for preoperative MRI and/or computed tomography-positron emission tomography (CT-PET) scan and should receive intensive postoperative surveillance.

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The timing of liver-only and systemic recurrence following LR for CLM.
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Fig1: The timing of liver-only and systemic recurrence following LR for CLM.

Mentions: After initial LR, patients underwent regular clinical assessment, serial serum CEA measurement and surveillance CT scans at 1 and 2 years postoperatively. In this study, early recurrence was defined by the presence of either liver-only or systemic (with or without liver involvement) disease within 18 months after liver resection. Eighteen months was selected as a cut-off based on an analysis of the timing and pattern of postoperative recurrence in the entire cohort. The reason for opting for this time period is illustrated in Figure 1. Most liver-only and systemic recurrence occurred with 18 months following LR.Figure 1


Predictors of early recurrence after resection of colorectal liver metastases.

Bhogal RH, Hodson J, Bramhall SR, Isaac J, Marudanayagam R, Mirza DF, Muiesan P, Sutcliffe RP - World J Surg Oncol (2015)

The timing of liver-only and systemic recurrence following LR for CLM.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389659&req=5

Fig1: The timing of liver-only and systemic recurrence following LR for CLM.
Mentions: After initial LR, patients underwent regular clinical assessment, serial serum CEA measurement and surveillance CT scans at 1 and 2 years postoperatively. In this study, early recurrence was defined by the presence of either liver-only or systemic (with or without liver involvement) disease within 18 months after liver resection. Eighteen months was selected as a cut-off based on an analysis of the timing and pattern of postoperative recurrence in the entire cohort. The reason for opting for this time period is illustrated in Figure 1. Most liver-only and systemic recurrence occurred with 18 months following LR.Figure 1

Bottom Line: Dukes C stage and male sex were significantly associated with early liver-only recurrence (P < 0.05).Tumour size ≥3.6 cm and tumour number (>2) were significantly associated with early systemic recurrence (P < 0.001).High-risk patients may be candidates for preoperative MRI and/or computed tomography-positron emission tomography (CT-PET) scan and should receive intensive postoperative surveillance.

View Article: PubMed Central - PubMed

Affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. balsin@hotmail.com.

ABSTRACT

Background: Early recurrence after resection of colorectal liver metastases (CLM) is common. Patients at risk of early recurrence may be candidates for enhanced preoperative staging and/or earlier postoperative imaging. The aim of this study was to determine if there are any risk factors that specifically predict early liver-only and systemic recurrence.

Methods: Retrospective analysis of prospective database of patients undergoing liver resection (LR) for CLM from 2004 to 2006 was undertaken. Early recurrence was defined as occurring within 18 months of LR. Patients were classified into three groups: early liver-only recurrence, early systemic recurrence and recurrence-free. Preoperative factors were compared between patients with and without early recurrence.

Results: Two hundred and forty-three consecutive patients underwent LR for CLM. Twenty-seven patients (11%) developed early liver-only recurrence. Dukes C stage and male sex were significantly associated with early liver-only recurrence (P < 0.05). Sixty-six patients (27%) developed early systemic recurrence. Tumour size ≥3.6 cm and tumour number (>2) were significantly associated with early systemic recurrence (P < 0.001).

Conclusions: It is possible to stratify patients according to the risk of early liver-only or systemic recurrence after resection of CLM. High-risk patients may be candidates for preoperative MRI and/or computed tomography-positron emission tomography (CT-PET) scan and should receive intensive postoperative surveillance.

Show MeSH
Related in: MedlinePlus