Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy
Background This study investigated the impact of perioperative systemic chemotherapy on the recurrence rate and pattern following resection of colorectal liver metastases. Methods A retrospective cohort study was conducted in two centers. Rates and patterns of recurrence and overall survival (OS) we...
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| Veröffentlicht in: | World journal of surgery 2020-03, Vol.44 (3), p.876-886 |
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| creator | Buisman, Florian E. Galjart, Boris van der Stok, Eric P. Balachandran, Vinod P. Boerner, Thomas Drebin, Jeffrey A. Grünhagen, Dirk J. Jarnagin, William R. Kingham, T. Peter Verhoef, Cornelis D’Angelica, Micheal I. Groot Koerkamp, Bas |
| description | Background
This study investigated the impact of perioperative systemic chemotherapy on the recurrence rate and pattern following resection of colorectal liver metastases.
Methods
A retrospective cohort study was conducted in two centers. Rates and patterns of recurrence and overall survival (OS) were compared between patients treated with and without perioperative systemic chemotherapy. The clinical risk score (CRS) was used to stratify patients in low risk (CRS 0–2) and high risk (CRS 3–5) of recurrence.
Results
A total of 2020 patients were included, of whom 1442 (71%) received perioperative systemic chemotherapy. The median follow-up was 88 months, and 1289 patients (64%) developed a recurrence. The recurrence pattern was independent of chemotherapy in low-risk patients: intrahepatic recurrences (30% vs. 30%,
p
= 0.97) and extrahepatic recurrences (38% vs. 39%,
p
= 0.52). In high-risk patients, no difference in intrahepatic recurrences was found (48% vs. 50%,
p
= 0.59). However, a lower rate of extrahepatic recurrences (43% vs. 55%,
p
= 0.007) was observed with perioperative systemic chemotherapy, mainly due to a reduction in pulmonary recurrences (25% vs. 35%,
p
= 0.007). In competing risk analysis, the cumulative incidence of extrahepatic recurrence was significantly lower with perioperative systemic chemotherapy in high-risk patients only (5-year cumulative incidence 44% vs. 59%,
p
|
| doi_str_mv | 10.1007/s00268-019-05121-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7668197</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2272483432</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5530-63eb040ef96ed0ba6777116b5b493825af1b23fa8e7ba16d254eaaeb0214ccb53</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhi0EokvhD3BAlrhwCdiexE44IJUV5UNbUbUgjpbjTLquknhrZ7fKv6-XlPJxqJAsjT1-3tE7egl5ztlrzph6ExkTsswYrzJWcMGz6gFZ8BxEJkDAQ7JgIPN053BAnsR4yRhXksnH5AB4zpMEFmR3hnYbAg4W6akZRwxDpEdtqvQMI9rR-YH6li5950N6mo6u3C79nuBoYjouUhOQnvjGtQ4bWk_0FIPzGwxmTCQ9n-KIvbN0ucbej-vU30xPyaPWdBGf3dZD8v34w7flp2z19ePn5dEqs0UBLJOANcsZtpXEhtVGKqU4l3VR5xWUojAtrwW0pkRVGy4bUeRoTNIInltbF3BI3s1zN9u6x8biMAbT6U1wvQmT9sbpv38Gt9YXfqeVlCWvVBrw6nZA8FdbjKPuXbTYdWZAv41aCAWCqwL26Mt_0Eu_DUNaT4sKQJYSCnYvJZTIS0gBJkrMlA0-xoDtnWXO9D58PYevU_j6Z_i6SqIXfy57J_mVdgLezsC163D6j5H6x5fz98eprfbGYRbHpBsuMPw2fo-nGxfhzNI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2272483432</pqid></control><display><type>article</type><title>Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Buisman, Florian E. ; Galjart, Boris ; van der Stok, Eric P. ; Balachandran, Vinod P. ; Boerner, Thomas ; Drebin, Jeffrey A. ; Grünhagen, Dirk J. ; Jarnagin, William R. ; Kingham, T. Peter ; Verhoef, Cornelis ; D’Angelica, Micheal I. ; Groot Koerkamp, Bas</creator><creatorcontrib>Buisman, Florian E. ; Galjart, Boris ; van der Stok, Eric P. ; Balachandran, Vinod P. ; Boerner, Thomas ; Drebin, Jeffrey A. ; Grünhagen, Dirk J. ; Jarnagin, William R. ; Kingham, T. Peter ; Verhoef, Cornelis ; D’Angelica, Micheal I. ; Groot Koerkamp, Bas</creatorcontrib><description>Background
This study investigated the impact of perioperative systemic chemotherapy on the recurrence rate and pattern following resection of colorectal liver metastases.
Methods
A retrospective cohort study was conducted in two centers. Rates and patterns of recurrence and overall survival (OS) were compared between patients treated with and without perioperative systemic chemotherapy. The clinical risk score (CRS) was used to stratify patients in low risk (CRS 0–2) and high risk (CRS 3–5) of recurrence.
Results
A total of 2020 patients were included, of whom 1442 (71%) received perioperative systemic chemotherapy. The median follow-up was 88 months, and 1289 patients (64%) developed a recurrence. The recurrence pattern was independent of chemotherapy in low-risk patients: intrahepatic recurrences (30% vs. 30%,
p
= 0.97) and extrahepatic recurrences (38% vs. 39%,
p
= 0.52). In high-risk patients, no difference in intrahepatic recurrences was found (48% vs. 50%,
p
= 0.59). However, a lower rate of extrahepatic recurrences (43% vs. 55%,
p
= 0.007) was observed with perioperative systemic chemotherapy, mainly due to a reduction in pulmonary recurrences (25% vs. 35%,
p
= 0.007). In competing risk analysis, the cumulative incidence of extrahepatic recurrence was significantly lower with perioperative systemic chemotherapy in high-risk patients only (5-year cumulative incidence 44% vs. 59%,
p
< 0.001). Perioperative chemotherapy was associated with improved OS in high-risk patients (adjusted HR 0.73, 95% CI 0.57–0.94,
p
= 0.02), but not in low-risk patients (adjusted HR 0.99, 95% CI 0.82–1.19,
p
= 0.90).
Conclusions
Perioperative systemic chemotherapy had no association with intrahepatic recurrence, but was associated with fewer pulmonary recurrences and superior OS in high-risk patients only.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05121-9</identifier><identifier>PMID: 31410513</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Aged ; Cardiac Surgery ; Chemotherapy ; Colorectal cancer ; Colorectal Neoplasms - pathology ; Female ; General Surgery ; Humans ; Incidence ; Liver ; Liver Neoplasms - drug therapy ; Liver Neoplasms - mortality ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Male ; Mastectomy ; Medicine ; Medicine & Public Health ; Metastases ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Original Scientific Report ; Retrospective Studies ; Risk analysis ; Risk groups ; Surgery ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-03, Vol.44 (3), p.876-886</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><rights>Société Internationale de Chirurgie 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5530-63eb040ef96ed0ba6777116b5b493825af1b23fa8e7ba16d254eaaeb0214ccb53</citedby><cites>FETCH-LOGICAL-c5530-63eb040ef96ed0ba6777116b5b493825af1b23fa8e7ba16d254eaaeb0214ccb53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-05121-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-05121-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31410513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Buisman, Florian E.</creatorcontrib><creatorcontrib>Galjart, Boris</creatorcontrib><creatorcontrib>van der Stok, Eric P.</creatorcontrib><creatorcontrib>Balachandran, Vinod P.</creatorcontrib><creatorcontrib>Boerner, Thomas</creatorcontrib><creatorcontrib>Drebin, Jeffrey A.</creatorcontrib><creatorcontrib>Grünhagen, Dirk J.</creatorcontrib><creatorcontrib>Jarnagin, William R.</creatorcontrib><creatorcontrib>Kingham, T. Peter</creatorcontrib><creatorcontrib>Verhoef, Cornelis</creatorcontrib><creatorcontrib>D’Angelica, Micheal I.</creatorcontrib><creatorcontrib>Groot Koerkamp, Bas</creatorcontrib><title>Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
This study investigated the impact of perioperative systemic chemotherapy on the recurrence rate and pattern following resection of colorectal liver metastases.
Methods
A retrospective cohort study was conducted in two centers. Rates and patterns of recurrence and overall survival (OS) were compared between patients treated with and without perioperative systemic chemotherapy. The clinical risk score (CRS) was used to stratify patients in low risk (CRS 0–2) and high risk (CRS 3–5) of recurrence.
Results
A total of 2020 patients were included, of whom 1442 (71%) received perioperative systemic chemotherapy. The median follow-up was 88 months, and 1289 patients (64%) developed a recurrence. The recurrence pattern was independent of chemotherapy in low-risk patients: intrahepatic recurrences (30% vs. 30%,
p
= 0.97) and extrahepatic recurrences (38% vs. 39%,
p
= 0.52). In high-risk patients, no difference in intrahepatic recurrences was found (48% vs. 50%,
p
= 0.59). However, a lower rate of extrahepatic recurrences (43% vs. 55%,
p
= 0.007) was observed with perioperative systemic chemotherapy, mainly due to a reduction in pulmonary recurrences (25% vs. 35%,
p
= 0.007). In competing risk analysis, the cumulative incidence of extrahepatic recurrence was significantly lower with perioperative systemic chemotherapy in high-risk patients only (5-year cumulative incidence 44% vs. 59%,
p
< 0.001). Perioperative chemotherapy was associated with improved OS in high-risk patients (adjusted HR 0.73, 95% CI 0.57–0.94,
p
= 0.02), but not in low-risk patients (adjusted HR 0.99, 95% CI 0.82–1.19,
p
= 0.90).
Conclusions
Perioperative systemic chemotherapy had no association with intrahepatic recurrence, but was associated with fewer pulmonary recurrences and superior OS in high-risk patients only.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Mastectomy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Original Scientific Report</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk groups</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1v1DAQhi0EokvhD3BAlrhwCdiexE44IJUV5UNbUbUgjpbjTLquknhrZ7fKv6-XlPJxqJAsjT1-3tE7egl5ztlrzph6ExkTsswYrzJWcMGz6gFZ8BxEJkDAQ7JgIPN053BAnsR4yRhXksnH5AB4zpMEFmR3hnYbAg4W6akZRwxDpEdtqvQMI9rR-YH6li5950N6mo6u3C79nuBoYjouUhOQnvjGtQ4bWk_0FIPzGwxmTCQ9n-KIvbN0ucbej-vU30xPyaPWdBGf3dZD8v34w7flp2z19ePn5dEqs0UBLJOANcsZtpXEhtVGKqU4l3VR5xWUojAtrwW0pkRVGy4bUeRoTNIInltbF3BI3s1zN9u6x8biMAbT6U1wvQmT9sbpv38Gt9YXfqeVlCWvVBrw6nZA8FdbjKPuXbTYdWZAv41aCAWCqwL26Mt_0Eu_DUNaT4sKQJYSCnYvJZTIS0gBJkrMlA0-xoDtnWXO9D58PYevU_j6Z_i6SqIXfy57J_mVdgLezsC163D6j5H6x5fz98eprfbGYRbHpBsuMPw2fo-nGxfhzNI</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Buisman, Florian E.</creator><creator>Galjart, Boris</creator><creator>van der Stok, Eric P.</creator><creator>Balachandran, Vinod P.</creator><creator>Boerner, Thomas</creator><creator>Drebin, Jeffrey A.</creator><creator>Grünhagen, Dirk J.</creator><creator>Jarnagin, William R.</creator><creator>Kingham, T. Peter</creator><creator>Verhoef, Cornelis</creator><creator>D’Angelica, Micheal I.</creator><creator>Groot Koerkamp, Bas</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><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>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202003</creationdate><title>Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy</title><author>Buisman, Florian E. ; Galjart, Boris ; van der Stok, Eric P. ; Balachandran, Vinod P. ; Boerner, Thomas ; Drebin, Jeffrey A. ; Grünhagen, Dirk J. ; Jarnagin, William R. ; Kingham, T. Peter ; Verhoef, Cornelis ; D’Angelica, Micheal I. ; Groot Koerkamp, Bas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5530-63eb040ef96ed0ba6777116b5b493825af1b23fa8e7ba16d254eaaeb0214ccb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Cardiac Surgery</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Liver</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Mastectomy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Original Scientific Report</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk groups</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buisman, Florian E.</creatorcontrib><creatorcontrib>Galjart, Boris</creatorcontrib><creatorcontrib>van der Stok, Eric P.</creatorcontrib><creatorcontrib>Balachandran, Vinod P.</creatorcontrib><creatorcontrib>Boerner, Thomas</creatorcontrib><creatorcontrib>Drebin, Jeffrey A.</creatorcontrib><creatorcontrib>Grünhagen, Dirk J.</creatorcontrib><creatorcontrib>Jarnagin, William R.</creatorcontrib><creatorcontrib>Kingham, T. Peter</creatorcontrib><creatorcontrib>Verhoef, Cornelis</creatorcontrib><creatorcontrib>D’Angelica, Micheal I.</creatorcontrib><creatorcontrib>Groot Koerkamp, Bas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buisman, Florian E.</au><au>Galjart, Boris</au><au>van der Stok, Eric P.</au><au>Balachandran, Vinod P.</au><au>Boerner, Thomas</au><au>Drebin, Jeffrey A.</au><au>Grünhagen, Dirk J.</au><au>Jarnagin, William R.</au><au>Kingham, T. Peter</au><au>Verhoef, Cornelis</au><au>D’Angelica, Micheal I.</au><au>Groot Koerkamp, Bas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-03</date><risdate>2020</risdate><volume>44</volume><issue>3</issue><spage>876</spage><epage>886</epage><pages>876-886</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
This study investigated the impact of perioperative systemic chemotherapy on the recurrence rate and pattern following resection of colorectal liver metastases.
Methods
A retrospective cohort study was conducted in two centers. Rates and patterns of recurrence and overall survival (OS) were compared between patients treated with and without perioperative systemic chemotherapy. The clinical risk score (CRS) was used to stratify patients in low risk (CRS 0–2) and high risk (CRS 3–5) of recurrence.
Results
A total of 2020 patients were included, of whom 1442 (71%) received perioperative systemic chemotherapy. The median follow-up was 88 months, and 1289 patients (64%) developed a recurrence. The recurrence pattern was independent of chemotherapy in low-risk patients: intrahepatic recurrences (30% vs. 30%,
p
= 0.97) and extrahepatic recurrences (38% vs. 39%,
p
= 0.52). In high-risk patients, no difference in intrahepatic recurrences was found (48% vs. 50%,
p
= 0.59). However, a lower rate of extrahepatic recurrences (43% vs. 55%,
p
= 0.007) was observed with perioperative systemic chemotherapy, mainly due to a reduction in pulmonary recurrences (25% vs. 35%,
p
= 0.007). In competing risk analysis, the cumulative incidence of extrahepatic recurrence was significantly lower with perioperative systemic chemotherapy in high-risk patients only (5-year cumulative incidence 44% vs. 59%,
p
< 0.001). Perioperative chemotherapy was associated with improved OS in high-risk patients (adjusted HR 0.73, 95% CI 0.57–0.94,
p
= 0.02), but not in low-risk patients (adjusted HR 0.99, 95% CI 0.82–1.19,
p
= 0.90).
Conclusions
Perioperative systemic chemotherapy had no association with intrahepatic recurrence, but was associated with fewer pulmonary recurrences and superior OS in high-risk patients only.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31410513</pmid><doi>10.1007/s00268-019-05121-9</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | World journal of surgery, 2020-03, Vol.44 (3), p.876-886 |
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| source | MEDLINE; Wiley Online Library All Journals; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Aged Cardiac Surgery Chemotherapy Colorectal cancer Colorectal Neoplasms - pathology Female General Surgery Humans Incidence Liver Liver Neoplasms - drug therapy Liver Neoplasms - mortality Liver Neoplasms - secondary Liver Neoplasms - surgery Male Mastectomy Medicine Medicine & Public Health Metastases Middle Aged Neoplasm Recurrence, Local - epidemiology Original Scientific Report Retrospective Studies Risk analysis Risk groups Surgery Thoracic Surgery Vascular Surgery |
| title | Recurrence Patterns After Resection of Colorectal Liver Metastasis are Modified by Perioperative Systemic Chemotherapy |
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