Prognostic factors and time-related changes influence results of colorectal liver metastases surgical treatment: A single-center analysis

Abstract

AIM: To analyze the prognostic factors involved in survival and cancer recurrence in patients undergoing surgical treatment for colorectal liver metastases (CLM) and to describe the effects of time-related changes on survival and recurrence in these patients. METHODS:From January 1994 to January 2006, 236 patients with CLM underwent surgery with the aim of performing curative resection of neoplastic disease at our institution and 189 (80%) of these patients underwent resection of CLM with curative intention. Preoperative, intraoperative and postoperative data, including primary tumor and CLM pathology results, were retrospectively reviewed. Patients were divided into two time periods: a first period from January 1994 to January 2000 (n = 93), and a second period from February 2000 to January 2006 (n = 143). RESULTS:Global survival at 1, 3 and 5 years in patients undergoing hepatic resection was 91%, 54% and 47%, respectively. Patients with preoperative extrahepatic disease, carcinoembryonic antigen (CEA) levels over 20 ng/dL, more than four nodules or extrahepatic invasion at pathological analysis had worse survival. Tumor recurrence rate at 1 year was 48.3%, being more frequent in patients with preoperative and pathological extrahepatic disease and CEA levels over 20 ng/dL. Although patients in the second time period had more adverse prognostic fa c t o r s , no di ffe re nc e s in ove ra l l s ur v iva l a n d recurrence were observed between the two periods. CONCLUSION:Despite advances in surgical technique and better adjuvant treatments and preoperative imaging, careful patient staging and selection is crucial to continue offering a chance of cure to patients with CLM.

Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors

“…Of the studies identified, six included in our analyses23–28 were also included in the earlier literature review by Simmonds et al,15 published in 2006. A total of 116 articles were identified that reported survival after liver resection in adults with mCRC and the modifying effect (if any) of other personal and clinical factors on survival 3,4,10–14,16,17,23–127. After accounting for overlap of multiple publications reporting on patients from the same center (34 articles), our review included a total of approximately 20,745 patients (range: 21–1600 patients per study).…”

Carcinoembryonic Antigen as a Prognostic Factor in Colorectal Cancer with Liver Metastases

“…Wang et al used this value in a similar preoperative CEA study, as did Mitsuyama et al in a study looking at the use of CEA in a group of patients with unresectable disease [14] [19]. Other literature used cut-off values ranging from 20 to 200 ng/mL, thus 100 ng/mL did not seem inappropriate in the context of this study [11]- [13] [21] [22].…”

The Role of Routine Clinical Pretreatment 18F-FDG PET/CT in Predicting Outcome of Colorectal Liver Metastasis

“…For the clinical factors, the threshold values used for dichotomization were adopted from previously published figures. 16,17 For the metabolic parameters, threshold values derived from receiver operating characteristic (ROC) analysis for distinguishing progressors from nonprogressors and for distinguishing nonsurvivors from survivors were used ( Table 1).…”