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World Journal of Surgery, 2001
Hepatectomy for liver metastases from colorectal cancer has recently received general acceptance ... more Hepatectomy for liver metastases from colorectal cancer has recently received general acceptance as a safe, potentially curative treatment. Most patients, however, die of recurrent disease after hepatectomy. The predictive factors for recurrence after first resection of liver metastases have not yet been clarified. The authors aimed to determine the factors that can predict recurrence, especially hepatic-only recurrence after hepatectomy for colorectal liver metastases. Seventy-six patients who underwent liver resection of colorectal metastases were studied retrospectively. Forty-seven (61.8%) of the patients had a recurrence. The patients' disease-free survival after first hepatectomy and the second recurrence sites were univariately and multivariately analyzed using 16 clinicopathologic variables. Wall invasion, lymph node metastases, lymphatic invasion, venous invasion of the primary tumor, 24 months or longer disease-free interval after resection of the primary colorectal cancer, and bilateral liver metastases significantly influenced the disease-free survival (log-rank test: p< 0.05). The multivariate analysis revealed that venous invasion of the primary tumor and bilateral hepatic metastases were independent risk factors for recurrence after hepatectomy. The liver was the only site of second recurrence in 23 patients. Patients with lymph node metastases and venous invasion of the primary tumor had a significant difference between hepatic-only and extrahepatic recurrence after first hepatectomy (chi-square test or Fishers' exact test: p < 0.05). Recurrence after hepatectomy was influenced more by factors associated with the primary colorectal cancer than factors surrounding the first liver metastases. Venous invasion of the primary colorectal cancer was the most important predictable factor for hepatic-only second recurrence. Hepatectomy for liver metastases from colorectal cancer has received general acceptance as a safe, potentially curative treatment [1-3]. Many patients, however, die of recurrent disease after hepatectomy. The recurrence is frequently in the remnant liver. Recently, some authors reported that the patients with isolated liver recurrence after hepatectomy have a chance of long-term survival or cure after repeat hepatectomy [4-6]. Therefore it is important to determine the predictive factors for recurrence after colorectal liver metastases. In this study we investigated the pattern of a second recurrence and analyzed the factors of the primary tumor and first liver metastases associated with the second recurrence, especially hepatic-only recurrence.
World Journal of Surgery, 2001
Hepatectomy for liver metastases from colorectal cancer has recently received general acceptance ... more Hepatectomy for liver metastases from colorectal cancer has recently received general acceptance as a safe, potentially curative treatment. Most patients, however, die of recurrent disease after hepatectomy. The predictive factors for recurrence after first resection of liver metastases have not yet been clarified. The authors aimed to determine the factors that can predict recurrence, especially hepatic-only recurrence after hepatectomy for colorectal liver metastases. Seventy-six patients who underwent liver resection of colorectal metastases were studied retrospectively. Forty-seven (61.8%) of the patients had a recurrence. The patients' disease-free survival after first hepatectomy and the second recurrence sites were univariately and multivariately analyzed using 16 clinicopathologic variables. Wall invasion, lymph node metastases, lymphatic invasion, venous invasion of the primary tumor, 24 months or longer disease-free interval after resection of the primary colorectal cancer, and bilateral liver metastases significantly influenced the disease-free survival (log-rank test: p< 0.05). The multivariate analysis revealed that venous invasion of the primary tumor and bilateral hepatic metastases were independent risk factors for recurrence after hepatectomy. The liver was the only site of second recurrence in 23 patients. Patients with lymph node metastases and venous invasion of the primary tumor had a significant difference between hepatic-only and extrahepatic recurrence after first hepatectomy (chi-square test or Fishers' exact test: p < 0.05). Recurrence after hepatectomy was influenced more by factors associated with the primary colorectal cancer than factors surrounding the first liver metastases. Venous invasion of the primary colorectal cancer was the most important predictable factor for hepatic-only second recurrence. Hepatectomy for liver metastases from colorectal cancer has received general acceptance as a safe, potentially curative treatment [1-3]. Many patients, however, die of recurrent disease after hepatectomy. The recurrence is frequently in the remnant liver. Recently, some authors reported that the patients with isolated liver recurrence after hepatectomy have a chance of long-term survival or cure after repeat hepatectomy [4-6]. Therefore it is important to determine the predictive factors for recurrence after colorectal liver metastases. In this study we investigated the pattern of a second recurrence and analyzed the factors of the primary tumor and first liver metastases associated with the second recurrence, especially hepatic-only recurrence.