Survival after hepatic resection in metastatic colorectal cancer

Cummings, Linda C.; Payes, Jonathan; Cooper, Gregory S.

doi:10.1002/cncr.22448

Cited by 300 publications

(201 citation statements)

References 26 publications

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“…A recent population-based study investigated the benefits of hepatic resection in colon cancer patients diagnosed with liver metastases (Cummings et al, 2007). In this study, the investigators evaluated the outcomes of patients who underwent resection to those who did not.…”

Section: Discussionmentioning

confidence: 99%

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

et al. 2007

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Studies suggest improved survival following resection of colorectal cancer liver metastases (CLMs). We investigated predictors of survival among patients with CLM who underwent hepatic resection using the SEER-Medicare database to identify patients X65 years diagnosed with CLM, 1991CLM, -2003, who underwent hepatectomy. Cox proportional hazards models were used to identify factors associated with survival after hepatectomy. Of 923 patients with CLM who underwent hepatectomy, 514 were stages I -III and developed CLM46 months after diagnosis (metachronous), and 409 were stage IV with CLM at diagnosis (synchronous). From the date of hepatectomy, 5 year survival was 22%; younger age, being married, female gender, surgery in an NCI-designated cancer centre, fewer comorbidities, fewer positive lymph nodes, and lower grade were associated with improved survival. Both 5-fluorouracil (5FU)-based chemotherapy and hepatic arterial infusion (HAI) of floxuridine-based chemotherapy following hepatectomy improved survival (HR ¼ 0.62, 95% CI: 0.50 -0.78; HR ¼ 0.51, 95% CI: 0.28 -0.97, respectively) in the synchronous, but not metachronous, group. The HR for overall mortality was higher in hospitals with a high vs low procedure volume (0.75, 95% CI: 0.58 -0.94). A substantial subgroup of patients with CLM who undergo hepatectomy experiences long-term survival. High hospital procedure volume and use of 5FU-based or HAI-based chemotherapy after resection were associated with improved prognosis.

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Section: Discussionmentioning

confidence: 99%

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

et al. 2007

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“…Hepatic resection is the treatment of choice for liver cancer if metastases are confined to the liver, and may achieve a 5 years survival of 25%-39% [1][2][3][4] . Resectability is usually determined by the absence of extrahepatic metastases, a maximum of four lesions in the liver and the ability to obtain cancerfree resection margins [5] .Therefore, only 10%-20% of patients with hepatic colorectal metastases are suitable www.wjgnet.com for resection [6] . For non-resectable liver metastases, chemotherapy or chemoembolization are often used, but the outcome is poor.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous cryosurgery for the treatment of hepatic colorectal metastases

Niu²,

He³

et al. 2008

WJG

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AIM:To determine the safety and efficacy of efficacy of percutaneous cryosurgery for treatment of patients with hepatic colorectal metastases. METHODS:Three hundred and twenty-six patients with non-resectable hepatic colorectal metastases underwent percutaneous cryosurgery under the guidance of ultrasound or CT. Follow-up was 1 mo after cryosurgery and then every 4 mo thereafter by assessment of tumor markers, liver ultrasonography, and abdominal CT. For lesions suspicious of recurrence, a liver biopsy was performed and subsequent repeat cryosurgery was given if histology was positive for cancer. RESULTS:All patients underwent a total of 526 procedures of cryosurgery. There were 151 patients who underwent repeat procedures of cryosurgery for recurrent tumors in the liver and extrahepatic places. At 3 mo after cryosurgery, carcinoembryonic antigen (CEA) levels in 197 (77.5%) patients who had elevated markers before cryosurgery decreased to normal range. Among 280 patients who received CT following-up, cryotreated lesions showed complete response (CR) in 41 patients (14.6%), partial response (PR) in 115 patients (41.1%), stable disease (SD) in 68 patients (24.3%) and progressive disease (PD) in 56 patients (20%). The recurrence rate was 47.2% during a median follow-up of 32 mo (range, 7-61). Sixty one percent of the recurrences were seen in liver only and 13.9% in liver and extrahepatic areas. The recurrence rate at cryotreated site was only 6.4% for all cases. During a median follow-up of 36 mo (7-62 mo), the median survival of all patient was 29 mo (range 3-62 mo). Overall survival was 78%, 62%, 41%, 34% and 23% at 1, 2, 3, 4 and 5 years, respectively, after the treatment. Patients with tumor size less than 3 cm, tumor in right lobe of liver, lower CEA levels (< 100 ng/dL) and postcryosurgery TACE had higher survival rate. There was no significant difference in terms of survival based on the number of tumors, pre-cryosurgery chemotherapy and the timing of the development of metastases (synchronous vs metachronous). Patients who underwent 2-3 procedures of cryosurgery had increased survival compared to patients who received cryosurgery once only. There was no intra-cryosurgery mortality. Main adverse effects, such as hepatic bleeding, cryoshock, biliary fistula, liver failure, renal insufficiency and liver abscess were only observed in 0.3%-1.5% of patients.CONCLUSION:Percutaneous cryosurgery was a safe modality for hepatic colorectal metastases. Rather than an alternative to resection, this technique should be regarded as a complement to hepatectomy and as an additional means of achieving tumor eradication when total excision is not possible.

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“…Like most of population-based studies, only overall survival was compared. 10,11 Statistical Methods Overall survival was defined as the time from the diagnosis to death, and was estimated by life-table analysis. Survival curves were calculated according to the KaplanMeier method and compared by the log-rank test.…”

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confidence: 99%

Multicenter analysis of lung cancer patients younger than 45 years in Shanghai

Zhang

Chen

Zhen

et al. 2010

Cancer

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BACKGROUND:The treatment, prognosis, and outcomes of young lung cancer patients have not been fully explored. In addition, there is a pressing need to characterize this subgroup of patients, because there is a trend of increasing incidence in younger patients from Europe and Japan. METHODS: Consecutive, nonselected young patients (<45 years old) with pathologically diagnosed lung cancer treated at 175 qualified hospitals in the greater Shanghai area were included in this analysis. Incidence, prognostic factors, and treatment outcome of lung cancer patients from 2002 to 2006 were documented. A comparison with lung cancer patients of any age was also made. RESULTS: A total of 12,380 patients with nonsmall cell lung cancer were registered. Among them, 652 patients were between 15 and 45 years old. One-year, 3-year, and 5-year survival rates of lung cancer patients younger than 45 years were 49.87%, 26.68%, and 23.12%, respectively. TNM stage, treatment hospital (tertiary vs community hospital), sex, and cancer histology were confirmed as independent prognostic factors. Compared with lung cancer patients of any age in Shanghai, the percentage of adenocarcinoma in the young male subgroup was significantly higher (63.77% vs 43.19%, P < .001). Interestingly, median survival time of young lung cancer patients was similar with that of lung cancer patients of any age, but was significantly shorter than the median survival of middle-aged patients (45-60 years old). CONCLUSIONS: Median survival of the middle-aged group (45-60 years) was significantly longer than the young group (<45 years) and the old group (>60 years). Therefore, aggressive treatment modalities should be strongly considered for young lung cancer patients. Cancer 2010;116;3656-62.

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Survival after hepatic resection in metastatic colorectal cancer

Cited by 300 publications

References 26 publications

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

Percutaneous cryosurgery for the treatment of hepatic colorectal metastases

Multicenter analysis of lung cancer patients younger than 45 years in Shanghai

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