+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Survival outcomes of patients with colorectal liver metastases following hepatic resection or ablation in the era of effective chemotherapy



Survival outcomes of patients with colorectal liver metastases following hepatic resection or ablation in the era of effective chemotherapy



Annals of Surgical Oncology 16(7): 1860-1867



The outcome of patients with colorectal liver metastases (CLM) undergoing surgical resection in the era of effective chemotherapy is not widely reported. In addition, factors associated with disease-specific survival (DSS) in a contemporary series of patients are not well defined. Clinical, pathologic, and outcome data for 64 patients with CLM treated by a single surgeon in a multidisciplinary setting from February 2002 to October 2007 were examined. Hepatic resection was combined with radiofrequency ablation (RFA) in 23 (36%) cases. Secondary or tertiary resection was undertaken in 12 (19%) patients. Synchronous CLM were noted in 25 (39%) cases. Neoadjuvant chemotherapy was given to 41 (64%) patients. Following hepatic resection, adjuvant chemotherapy was administered in 52 (81%) cases. There was one (2%) operative mortality. One or more complications were noted in 24 (38%) patients. Median length of hospital stay was 7 (2-7) days. Five-year DSS and overall survival were 72% and 69%, respectively. Bilobar disease (p < 0.001), local tumor extension (p = 0.02), response to neoadjuvant chemotherapy (p = 0.005), preoperative portal vein embolization (p = 0.05), number of hepatic lesions (p = 0.03), positive resection margin (p < 0.001), and node-positive primary disease (p = 0.001) were prognostically significant factors on univariate analysis. On multivariate analysis, bilobar disease (p = 0.02) and local tumor extension (p = 0.02) were the only two independent prognostic factors. We conclude that, in patients with CLM, a multidisciplinary approach encompassing an aggressive surgical policy achieves excellent 5-year survival results with acceptable operative morbidity and mortality. Bilobar disease and local extrahepatic extension of cancer appear to be independent prognostic factors for long-term survival.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056044677

Download citation: RISBibTeXText

PMID: 19037703

DOI: 10.1245/s10434-008-0225-3


Related references

Hepatic resection combined with radiofrequency ablation for initially unresectable colorectal liver metastases after effective chemotherapy is a safe procedure with a low incidence of local recurrence. International Journal of Clinical Oncology 18(5): 847-855, 2013

Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Annals of Surgery 239(6): 818, 2004

The effect of hepatic steatosis on survival following resection of colorectal liver metastases in patients without preoperative chemotherapy. Hpb 15(6): 463-472, 2013

Longterm results and prognostic indicators after cryotherapy and hepatic arterial chemotherapy with or without resection for colorectal liver metastases in 224 patients: longterm survival can be achieved in patients with multiple bilateral liver metastases. Journal of the American College of Surgeons 202(1): 100-111, 2006

Long-term survival after liver resection for colorectal liver metastases in patients with hepatic pedicle lymph nodes involvement in the era of new chemotherapy regimens. Annals of Surgery 249(6): 879-886, 2009

Colorectal liver metastases: recurrence and survival following hepatic resection, radiofrequency ablation, and combined resection-radiofrequency ablation. Archives of Surgery 143(12): 1204-1212, 2008

Conversion to complete resection and/or ablation using hepatic artery infusional chemotherapy in patients with unresectable liver metastases from colorectal cancer: a decade of experience at a single institution. Annals of Surgical Oncology 20(9): 2901-2907, 2013

Long-term outcomes following hepatic resection and radiofrequency ablation of colorectal liver metastases. Hpb Surgery 2009: 346863, 2009

Feasibility of adjuvant hepatic arterial infusion of chemotherapy after radiofrequency ablation with or without resection in patients with hepatic metastases from colorectal cancer. Annals of Surgical Oncology 10(4): 348-354, 2003

Median overall survival in patients with colorectal hepatic metastases: Hepatic resection versus systemic chemotherapy. European Journal of Surgical Oncology (Ejso) 38(9): 794-795, 2012

Recurrence and survival outcomes after hepatic resection with or without cryotherapy for liver metastases from colorectal carcinoma. Annals of Surgical Oncology 14(7): 2078-2087, 2007

Adjuvant chemotherapy after resection of colorectal liver metastases in patients at high risk of hepatic recurrence: a comparative study between hepatic arterial infusion of oxaliplatin and modern systemic chemotherapy. Annals of Surgery 257(1): 114-120, 2013

Chemotherapy for colorectal cancer prior to liver resection for colorectal cancer hepatic metastases does not adversely affect peri-operative outcomes. Journal of Surgical Oncology 95(1): 22-27, 2007

Evolving techniques in the treatment of liver colorectal metastases: role of laparoscopy, radiofrequency ablation, microwave coagulation, hepatic arterial chemotherapy, indications and contraindications for resection, role of transplantation, and timing of chemotherapy. Surgical Clinics of North America 86(4): 1005-1022, 2006

Hepatic resection may improve survival in patients with synchronic colorectal liver metastases operated on for obstructed stage iv colorectal cancer. Hpb 18: E183-E184, 2016