Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases
Up to three‐quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short‐ and long‐term outcomes following...
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| Veröffentlicht in: | Cancer medicine (Malden, MA) MA), 2017-02, Vol.6 (2), p.331-338 |
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| creator | Neal, Christopher P. Nana, Gael R. Jones, Michael Cairns, Vaux Ngu, Wee Isherwood, John Dennison, Ashley R. Garcea, Giuseppe |
| description | Up to three‐quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short‐ and long‐term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi‐squared test. Variables associated with long‐term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer‐specific survival following index hepatectomy. Short disease‐free interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short‐term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved long‐term patient survival.
Hepatic resection offers the only hope of cure to patients with colorectal liver metastases (CRLM), with repeat hepatic resection emerging as a viable therapy for patients with recurrent CRLM following initial resection. This study analyzes the survival of a cohort of 488 patients who had undergone hepatic resection for CRLM, finding the performance of repeat hepatectomy to be independently associated with prolonged overall and cancer‐specific survival following hepatectomy. |
| doi_str_mv | 10.1002/cam4.872 |
| format | Article |
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Hepatic resection offers the only hope of cure to patients with colorectal liver metastases (CRLM), with repeat hepatic resection emerging as a viable therapy for patients with recurrent CRLM following initial resection. This study analyzes the survival of a cohort of 488 patients who had undergone hepatic resection for CRLM, finding the performance of repeat hepatectomy to be independently associated with prolonged overall and cancer‐specific survival following hepatectomy.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.872</identifier><identifier>PMID: 28101946</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Abdomen ; Adult ; Aged ; Aged, 80 and over ; Cancer ; Clinical Cancer Research ; Colorectal cancer ; Colorectal Neoplasms - surgery ; Female ; Hepatectomy ; Humans ; Intensive care ; Liver ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Male ; Medical prognosis ; metastasectomy ; Metastases ; Metastasis ; Middle Aged ; Morbidity ; Mortality ; Neoplasm Recurrence, Local - surgery ; Original Research ; Patients ; Prognosis ; Regression analysis ; Reoperation ; Studies ; Surgery ; Survival ; Survival Analysis ; Treatment Outcome</subject><ispartof>Cancer medicine (Malden, MA), 2017-02, Vol.6 (2), p.331-338</ispartof><rights>2016 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.</rights><rights>2017. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4382-ff27fef7351ce295d7e87e8f5b334d1017852f5ca8f1b8e838cf1b4c714308f33</citedby><cites>FETCH-LOGICAL-c4382-ff27fef7351ce295d7e87e8f5b334d1017852f5ca8f1b8e838cf1b4c714308f33</cites><orcidid>0000-0002-7193-2695</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313635/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313635/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28101946$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neal, Christopher P.</creatorcontrib><creatorcontrib>Nana, Gael R.</creatorcontrib><creatorcontrib>Jones, Michael</creatorcontrib><creatorcontrib>Cairns, Vaux</creatorcontrib><creatorcontrib>Ngu, Wee</creatorcontrib><creatorcontrib>Isherwood, John</creatorcontrib><creatorcontrib>Dennison, Ashley R.</creatorcontrib><creatorcontrib>Garcea, Giuseppe</creatorcontrib><title>Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>Up to three‐quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short‐ and long‐term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi‐squared test. Variables associated with long‐term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer‐specific survival following index hepatectomy. Short disease‐free interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short‐term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved long‐term patient survival.
Hepatic resection offers the only hope of cure to patients with colorectal liver metastases (CRLM), with repeat hepatic resection emerging as a viable therapy for patients with recurrent CRLM following initial resection. This study analyzes the survival of a cohort of 488 patients who had undergone hepatic resection for CRLM, finding the performance of repeat hepatectomy to be independently associated with prolonged overall and cancer‐specific survival following hepatectomy.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Clinical Cancer Research</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Liver</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>metastasectomy</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Original Research</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Reoperation</subject><subject>Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>2045-7634</issn><issn>2045-7634</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kd9qFDEUxgdRbKkFn0AC3ngzNX8nmRuhLFqFSqHodchmTropmcmaZLbsjfgIfUafxCxb2yo0HJJD8p1fzuFrmtcEnxCM6XtrRn6iJH3WHFLMRSs7xp8_yg-a45yvcV0S006Sl80BVQSTnneHzc9LWIMpaAVrU8CWOG6Rz8hPQ72v21TCFpmco_X1fUA3vqyQM5uYzDIACnG6-v3rtkAaUZyLjSPUWlRZvpbmvdzGEFNlm4CC30BCIxSTa0B-1bxwJmQ4vjuPmu-fPn5bfG7PL86-LE7PW8uZoq1zVDpwkgligfZikKBqOLFkjA91FqkEdcIa5chSgWLK1oRbSTjDyjF21HzYc9fzcoTB1uaSCXqd_GjSVkfj9b8vk1_pq7jRghHWMVEB7-4AKf6YIRc9-mwhBDNBnLMmqiNCdqTf_fX2P-l1nNNUx9OU9rjHUvXyAWhTzDmBu2-GYL3zVe981dXXKn3zuPl74V8Xq6DdC258gO2TIL04_cp3wD_aHrBJ</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Neal, Christopher P.</creator><creator>Nana, Gael R.</creator><creator>Jones, Michael</creator><creator>Cairns, Vaux</creator><creator>Ngu, Wee</creator><creator>Isherwood, John</creator><creator>Dennison, Ashley R.</creator><creator>Garcea, Giuseppe</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7193-2695</orcidid></search><sort><creationdate>201702</creationdate><title>Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases</title><author>Neal, Christopher P. ; 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Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short‐ and long‐term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi‐squared test. Variables associated with long‐term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer‐specific survival following index hepatectomy. Short disease‐free interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short‐term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved long‐term patient survival.
Hepatic resection offers the only hope of cure to patients with colorectal liver metastases (CRLM), with repeat hepatic resection emerging as a viable therapy for patients with recurrent CRLM following initial resection. This study analyzes the survival of a cohort of 488 patients who had undergone hepatic resection for CRLM, finding the performance of repeat hepatectomy to be independently associated with prolonged overall and cancer‐specific survival following hepatectomy.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>28101946</pmid><doi>10.1002/cam4.872</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7193-2695</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Adult Aged Aged, 80 and over Cancer Clinical Cancer Research Colorectal cancer Colorectal Neoplasms - surgery Female Hepatectomy Humans Intensive care Liver Liver Neoplasms - secondary Liver Neoplasms - surgery Male Medical prognosis metastasectomy Metastases Metastasis Middle Aged Morbidity Mortality Neoplasm Recurrence, Local - surgery Original Research Patients Prognosis Regression analysis Reoperation Studies Surgery Survival Survival Analysis Treatment Outcome |
| title | Repeat hepatectomy is independently associated with favorable long‐term outcome in patients with colorectal liver metastases |
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