Multivariate analysis of the prognostic factors of patients with unresectable synchronous liver metastases from colorectal cancer

Yamamura, Takuya; Tsukikawa, Satoshi; Akaishi, O; Tanaka, Kazuyuki; Matsuoka, Hiromitsu; Hanai, Akira; Oikawa, Hiroshi; Ozasa, Takao; Kikuchi, Kenji; Matsuzaki, Hiroaki; Yamaguchi, Susumu

doi:10.1007/bf02070706

Cited by 23 publications

(20 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yamamura et al. [44] reviewed 73 cases with unresectable synchronous liver metastasis. They were divided into H1 (unilobar), H2 (< 4 bilobar) and H3 (> 5 bilobar).…”

Section: Resultsmentioning

confidence: 99%

“…Survival in the resected group might also improve because these patients are less likely to develop obstruction and perforation. Irinotecan and oxaliplatin Raised liver enzymes, age > 75 ***** Yun et al 43 Liver, peritoneum, lung 503 CEA, differentiation, resection, chemotherapy ******* Rosen et al 16 Liver, peritoneum 125 Age > 65, extensive liver involvement, carcinomatosis ******* Yamamura et al 44 Liver, peritoneum 73 Extent of liver metastases, number of nodes involved ****** Stelzner et al 45 Mainly liver 186 Performance status, CEA, metastatic load, chemotherapy ****** Goslin et al 46 Mainly liver 125 Metastatic load, degree of tumour differentiation ****** have been shown to result in significantly prolonged survival [51]. In the present review, four studies [28,[31][32][33] reported curative procedures in patients only with liver metastasis, after chemotherapy had shrunk the metastatic deposits.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

2012

View full text Add to dashboard Cite

show abstract

“…Yamamura et al. [44] reviewed 73 cases with unresectable synchronous liver metastasis. They were divided into H1 (unilobar), H2 (< 4 bilobar) and H3 (> 5 bilobar).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

2012

View full text Add to dashboard Cite

show abstract

“…Steele and Ravikumar 15 reported a median survival of 24 months in asymptomatic patients with three or fewer unresected metastases and 10 months for those with four or more. Scheele et al 16 reported a median survival of 14 months for patients with one to three unresected liver metastases, and Yamamura et al 17 reported a median survival of 13 and 12 months for patients with unresected metastases in one lobe and fewer than four metastases in both lobes, respectively.…”

Section: Discussionmentioning

confidence: 99%

Indicators for Treatment Strategies of Colorectal Liver Metastases

et al. 2000

View full text Add to dashboard Cite

ObjectiveTo analyze the survival predictors of patients undergoing hepatectomy for colorectal liver metastasis to determine useful indicators for therapy selection. Summary Background DataAlthough recurrence develops in more than two thirds of patients undergoing hepatectomy for colorectal liver metastasis, preoperative characteristics that might predict such recurrence have yet to be clearly identified. MethodsClinicopathologic data of 85 consecutive patients with colorectal cancer who underwent a curative resection of primary lesions and metastatic liver diseases at one institute were analyzed using the multivariate method with respect to both the metastatic state and the primary lesion. ResultsMultivariate analysis indicated that the aggressiveness of the primary tumor, early liver metastasis, and a large number of liver metastases were the characteristics that could be detected before hepatectomy and that independently indicated a worse survival. A three-ranked classification based on these coefficients (H-staging) was significantly related to both the recurrence rate within 6 months (7% in H-stage A, 30% in B, and 44% in C) and the 5-year survival rates (55%, 14%, and 0% respectively). An additional scoring system (HЈ-staging) based on the aggressiveness of the primary tumor and the level of carcinoembryonic antigen 1 to 3 months after hepatectomy was found to be related to the mode of subsequent recurrence and surgical resectability of the recurrent foci. ConclusionsH-staging can provide useful prognostic information for the treatment of liver metastasis. HЈ-staging could also help in predicting the possible mode of recurrence after hepatectomy and in determining the most suitable mode of additional therapy. Further multiinstitutional studies based on a large collective database will confirm the utility of these two staging systems.Hepatic resection is at present the treatment of choice for patients with colorectal metastases because it offers a reasonable chance of long-term survival.1 Nevertheless, because recurrence develops in many patients in a short period after hepatectomy, an improved set of indicators for surgical treatment is needed. Numerous investigators have reported the significance of several prognostic parameters, including liver-related characteristics (number, 2,3 distribution, 4 tumor diameter, 5,6 macroscopic type, 7 and satellite metastases 1 ), the time to liver metastasis, 1 the existence of extrahepatic disease, 8 the extent of liver resection, 1,3-6 age, 5 level of carcinoembryonic antigen (CEA), 3,5 and stage of the primary tumor.5 To date, however, few reliable selection criteria have been established with regard to treatment policies based on these variables. 5To assess the prognostic indicators, we reviewed a consecutive series of our patients with colorectal cancer and associated liver metastases. We examined several parameters and their relation to the prognostic outcome to determine whether any of these factors might be predictors of poor outcome and therefore useful in asse...

show abstract

“…Of twenty-three full-text articles that were excluded, twelve had no comparator nonsurgical group [27][28][29][30][31][32][33][34][35][36][37][38] ; four used a non-resection group (that is, ostomy procedures) as comparators [39][40][41][42] ; and another four used patients who underwent curative surgery as the comparator group [43][44][45][46] . Two studies, each with four comparator groups, provided minimal information about those groups, and one had a patient population that overlapped with the population of another study included in the present review 14,47 .…”

Section: Study Selectionmentioning

confidence: 99%

Should Noncurative Resection of the Primary Tumour Be Performed in Patients with Stage iv Colorectal Cancer? A Systematic Review and Meta-Analysis

et al. 2013

View full text Add to dashboard Cite

rate was 29.7% (95% ci: 18.5% to 41.0%), and the non-resection surgical procedures rate in the nonresection group was 27.6% (95 ci: 15.4% to 39.9%). No study provided qol data. ConclusionsAlthough this review supports primary tumour resection in advanced crc, the results have significant biases. Randomized trials are warranted to confirm the findings. KEY WORDSPrimary tumour resection, stage iv colorectal cancer, palliative surgery, survival INTRODUCTIONColorectal cancer (crc) is one of the leading causes of cancer death in North America 1 . The median overall survival of patients with stage iv crc managed with best supportive care alone is about 5-6 months 2 . Systemic therapy provides meaningful improvements in median survival and progression-free survival. Overall, with the judicious use of novel cytotoxic and biologic agents, the median overall survival of patients with stage iv crc has been extended to approximately 2 years [3][4][5] .The optimal surgical management of stage iv crc that is not amenable to curative resection is unknown. Although administration of systemic therapy in patients with stage iv crc may convert unresectable into resectable disease, the principal goal of treatment in most patients is to prolong survival, and only about 10%-15% patients are alive at 5 years. Consequently, in patients with stage iv crc, the potential morbidity of treatment and the treatment's impact on quality of life (qol) for the patient must be considered.Resection of the primary tumour in patients with stage iv cancer is often performed to deal with presenting primary tumour symptoms and ABSTRACT PurposeSurgical resection of the primary tumour in patients with advanced colorectal cancer (crc) remains controversial. This review compares survival in patients with advanced crc who underwent surgical resection of the primary tumour with that in patients not undergoing resection, and determines rates of postoperative mortality and nonfatal complications, the primary tumour complication rate, the non-resection surgical procedures rate, and quality of life (qol). MethodsReports in the central, medline, and embase databases were searched for relevant studies, which were selected using pre-specified eligibility criteria. The search was also restricted to publication dates from 1980 onward, the English language, and studies involving human subjects. Screening, evaluation of relevant articles, and data abstraction were performed in duplicate, and agreement between the abstractors was assessed. Articles that met the inclusion criteria were assessed for quality using the Newcastle-Ottawa Scale. Data were collected and synthesized per protocol. ResultsFrom among the 3379 reports located, fifteen retrospective observational studies were selected. Of the 12,416 patients in the selected studies, 8620 (69%) underwent surgery. Median survival was 15.2 months (range: 10-30.7 months) in the resection group and 11.4 months (range: 3-22 months) in the nonresection group. Hazard ratio for survival was 0.69 [95% confidence interval (ci): ...

show abstract

Multivariate analysis of the prognostic factors of patients with unresectable synchronous liver metastases from colorectal cancer

Abstract: Longevity of patients with unresectable synchronous liver metastases from colorectal cancer is affected adversely by the presence of nodal metastases and extent of liver metastases. This should be considered in the planning treatment.

Cited by 23 publications

References 8 publications

Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

Indicators for Treatment Strategies of Colorectal Liver Metastases

Should Noncurative Resection of the Primary Tumour Be Performed in Patients with Stage iv Colorectal Cancer? A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About