Predictors of cure after hepatic resection of colorectal liver metastases: An analysis of actual 5- and 10-year survivors

Background Hepatic resection of colorectal liver metastases (CLM) is now regarded the standard of care. Evaluation of true long‐term suvivors will demonstrate the curative potential of this therapy with cure being defined as actual 10‐year survival versus a satisfactory oncological outcome of 5‐year...

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Bibliographic Details
Published in:Journal of surgical oncology 2011-06, Vol.103 (8), p.796-800
Main Authors: Chua, Terence C., Saxena, Akshat, Chu, Francis, Zhao, Jing, Morris, David L.
Format: Article
Language:English
Subjects:
Chemotherapy, Adjuvant
colorectal cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Cryosurgery
cure
Disease-Free Survival
Female
Follow-Up Studies
hepatectomy
Hepatectomy - methods
Humans
Kaplan-Meier Estimate
liver metastasis
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
long-term survival
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
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Summary:Background Hepatic resection of colorectal liver metastases (CLM) is now regarded the standard of care. Evaluation of true long‐term suvivors will demonstrate the curative potential of this therapy with cure being defined as actual 10‐year survival versus a satisfactory oncological outcome of 5‐year survival. Limited data exists on outcomes of patients beyond 5 years. Studying the rates of cure and predictive factors for cure are essential to define the true benefit of this therapy. Methods Retrospectiv e review of a prospectively maintained hepatobiliary surgical database was performed on patients who underwent hepatic resection of CLM between 1991 and 2005 with a minimum of 5‐year follow‐up. Survival was calculated from the time of surgery using the Kaplan–Meier method. Results Ther e were 455 consecutive patients with a minimum of 5‐year follow‐up. The actuarial median overall survival was 33 months (95% CI, 29–37%), actuarial 5‐, and 10‐year survival rates were 34% and 25%, respectively. Hundred twenty four patients were identified as actual 5‐year survivors (27%) with their actuarial median overall survival being 11.1 years, actuarial 10‐year survival rate of 59%, and a median disease‐free survival of 4.9 years. Patients requiring subsequent treatment of modern systemic chemotherapy for post‐resection recurrence (P = 0.003) was a negative predictors of cure from multivariate analysis. Conclusion Thi s study demonstrate that approximately one in three patients undergoing resection for CLM will become actual 5‐year survivors from which approximately half will go on to survive 10‐years and be cured of CLM. J. Surg. Oncol. 2011;103:796–800. © 2011 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.21864