Rates and Patterns of Recurrence Following Curative Intent Surgery for Colorectal Liver Metastasis

Jong, Mechteld C. de; Pulitano, Carlo; Ribero, Dario; Strub, Jennifer; Mentha, Gilles; Schulick, Richard D.; Choti, Michael A.; Aldrighetti, Luca; Capussotti, Lorenzo; Pawlik, Timothy M.

doi:10.1097/sla.0b013e3181b4539b

Cited by 702 publications

(571 citation statements)

References 34 publications

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“…To our knowledge, no other studies have investigated the correlation of metabolic activity and extrahepatic disease recurrence. Other studies that investigated possible predictors of extrahepatic recurrence after curative-intent surgery, found the following characteristics associated with an increased risk: primary rectal tumour site, primary tumour lymph node metastasis, hepatic tumour size >5 cm, hepatic tumour number >4, as well as receipt of chemotherapy [32][33][34][35]. The lack of association between metabolic activity and extrahepatic disease in our cohort is remarkable as our results demonstrated a significant association between metabolic activity and OS.…”

Section: Modelcontrasting

confidence: 52%

18F-FDG PET as novel imaging biomarker for disease progression after ablation therapy in colorectal liver metastases

Samim

Prevoo

Veen

et al. 2017

Journal of Vascular and Interventional Radiology

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Purpose Recurrent disease following thermal ablation therapy is a frequently reported problem. Preoperative identification of patients with high risk of recurrent disease might enable individualized treatment based on patients' risk profile. The aim of the present work was to investigate the role of metabolic parameters derived from the pre-ablation 18 F-FDG PET/CT as imaging biomarkers for recurrent disease in patients with colorectal liver metastases (CLM). Methods Included in this retrospective study were all consecutive patients with CLM treated with percutaneous or open thermal ablation therapy who had a pre-treatment baseline 18 F-FDG PET/CT available. Multivariable cox regression for survival analysis was performed using different models for the metabolic parameters (SUL peak , SUL mean , SUL max , partial volume corrected SUL mean (cSUL mean ), and total lesion glycolysis (TLG)) corrected for tumour and procedure characteristics. The study endpoints were defined as local tumour progression free survival (LTP-FS), new intrahepatic recurrence free survival (NHR-FS) and extrahepatic recurrence free survival (EHR-FS). Clinical and imaging followup data was used as the reference standard. Results Fifty-four patients with 90 lesions were selected. Univariable cox regression analysis resulted in eight models. Multivariable analysis revealed that after adjusting for lesion size and the approach of the procedure, none of the metabolic parameters were associated with LTP-FS or EHR-FS. Percutaneous approach was significantly associated with a shorter LTP-FS. It was demonstrated that lower values of SUL peak , SUL max , SUL mean , and cSUL mean are associated with a significant better NHR-FS, independent of the lesion size and number and prior chemotherapy. Conclusion We found no association between the metabolic parameters on pre-ablation 18 F-FDG PET/CT and the LTP-FS. However, low values of the metabolic parameters were significantly associated with improved NHR-FS. The clinical implication of these findings might be the identification of high-risk patients who might benefit most from adjuvant or combined treatment strategies.

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Section: Modelcontrasting

confidence: 52%

18F-FDG PET as novel imaging biomarker for disease progression after ablation therapy in colorectal liver metastases

Samim

Prevoo

Veen

et al. 2017

Journal of Vascular and Interventional Radiology

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“…In most series, up to 25% of patients presenting with stage IV CRC undergo hepatic resection (Kopetz et al, 2009), with reported 5-year survival rates up to 50% (Taylor et al, 2010;Choti et al, 2002;Chua et al, 2011). However over one-half of patients will develop recurrence within 2 years (de Jong et al, 2009;Fong et al, 1999;Nordlinger et al, 1996), not getting any long-term survival benefit from hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore difficulties remain in deciding who is a good candidate for liver resection. Many studies have examined several clinical and pathological factors, including number and size of CLM, disease-free interval from primary to CLM, carcinoembryonic antigen (CEA) level, primary tumor stage, synchronous or metachronous CLM, as potential prognostic determinants of survival after surgical resection of CLM, in order to establish a preoperative scoring system that is able to predict the risk of recurrence after resection, and ultimately allows the selection of those patients who may benefit more from surgery (Choti et al, 2002;de Jong et al, 2009;Fong et al, 1999;Nordlinger et al, 1996;Mann et al, 2004;Nagashima et al, 2006a,b).…”

Section: Introductionmentioning

confidence: 99%

Can KRAS and BRAF mutations limit the benefit of liver resection in metastatic colorectal cancer patients? A systematic review and meta-analysis

Passiglia

Bronte

Bazan

et al. 2016

Critical Reviews in Oncology/Hematology

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Background: Clinical trials investigated the potential role of both KRAS and BRAF mutations, as prognostic biomarkers, in colorectal cancer (CRC) patients who underwent surgical treatment of CRC-related liver metastases (CLM), showing conflicting results. This meta-analysis aims to review all the studies reporting survival outcomes (recurrence free survival (RFS), and/or overall survival (OS)) of patients undergoing resection of CLM, stratified according to KRAS and/or BRAF mutation status. Materials and methods: Data from all published studies reporting survival outcomes (RFS and/or OS) of CRC patients who received resection of CLM, stratified by KRAS and/or BRAF mutation status were collected, according to the PRISMA guidelines. Pooled HRs were calculated for both the OS and/or RFS. Results: Seven eligible trials (1403 patients) were included. Pooled analysis showed that KRAS mutations predicted a significantly worse both RFS (HR: 1.65; 95% CI: 1.23-2.21) and OS (HR: 1.86; 95% CI: 1.51-2.30) in patients who underwent surgical resection of CLM. BRAF mutations were also associated with a significantly worse OS (HR: 3.90; 95% CI: 1.96-7.73) in this subgroup of patients. Conclusions: This meta-analysis suggests both KRAS and BRAF mutations as poor, prognostic biomarkers, associated with worse survival outcomes, in patients undergoing hepatic resection of CLM

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“…A large study involving 1666 patients from multiple institutions reported recurrence rates of 56.7% (Jong et al, 2009). Majority of recurrences was shown to be intrahepatic (43.2%).…”

Section: Discussionmentioning

confidence: 99%

Patterns of Lymph Node Recurrence in Colorectal Cancer Liver Metastases after Surgery: A Retrospective Longitudinal Study

Yong¹,

Houli²,

Starkey³

et al. 2017

CCO

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Background: Hepatic resection is the standard treatment for resectable colorectal cancer liver metastases. There is evidence that lymphatics play a role in disease recurrence post-surgery. The aim of this retrospective study is to assess patterns of lymph node recurrence after liver resection.Methods: Patients who had liver resection for colorectal cancer metastasis between 1 January 2010 and 31 December 2015 at 2 institutions in Melbourne, Australia were included. Data was collected from databases located at the 2 surgical centres.Results: Seventy-four patients were included in the study. Follow-up period was for a mean of 31.4 months. Lymph node recurrence was seen in 39.2% of patients during follow-up. Initial recurrence sites after hepatectomy was mainly in visceral-site only. Lymph node recurrences became more prominent during subsequent Recurrence Stages (RS) (RS1 -22.4%, RS2 -50.0%, RS3 -50.0%, RS4 -71.4%, RS5 -66.7%, and RS6 -0%). No predictive factor showed statistically significant relation to development of nodal recurrence.Conclusion: Lymph node recurrences after hepatic resection for liver metastases usually occur subsequent to a visceral-site only metastasis. There is no predictive factor as to which nodal group would be involved due to the complexity of liver lymphatic drainage.

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Rates and Patterns of Recurrence Following Curative Intent Surgery for Colorectal Liver Metastasis

Cited by 702 publications

References 34 publications

18F-FDG PET as novel imaging biomarker for disease progression after ablation therapy in colorectal liver metastases

18F-FDG PET as novel imaging biomarker for disease progression after ablation therapy in colorectal liver metastases

Can KRAS and BRAF mutations limit the benefit of liver resection in metastatic colorectal cancer patients? A systematic review and meta-analysis

Patterns of Lymph Node Recurrence in Colorectal Cancer Liver Metastases after Surgery: A Retrospective Longitudinal Study

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