Short time to recurrence after hepatic resection correlates with poor prognosis in colorectal hepatic metastasis

被引:64
作者
Takahashi, Shinichiro [1 ]
Konishi, Masaru [1 ]
Nakagohri, Toshio [1 ]
Gotohda, Naoto [1 ]
Saito, Norio [1 ]
Kinoshita, Taira [1 ]
机构
[1] Natl Canc Ctr Hosp E, Dept Surg, Kashiwa, Chiba 2778577, Japan
关键词
colorectal cancer; hepatic metastasis; resection; recurrence;
D O I
10.1093/jjco/hyl027
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Early recurrence is a major problem after hepatic resection of colorectal hepatic metastasis (CHM). Our aim was to investigate the relationship between time to recurrence after CHM resection and overall survival. Methods: A retrospective analysis was performed for 101 consecutive patients who underwent hepatic resection for CHM and have been followed more than 5 years. Results: Among 101 patients, 82 (81%) had a recurrence. Overall survival of patients with recurrence within 6 months after CHM resection was significantly worse than that of patients with recurrence after more than 6 months (P < 0.01). Overall survival was poorer when time to recurrence was shorter. One of the reasons for poor prognosis of patients with recurrence within 6 months was that only a few patients could undergo a second resection for recurrence after CHM resection. Histological type, including poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor, bilobar metastases, microscopic positive surgical margin and carcinoembryonic antigen (CEA) above 15 ng/ml had predictive value for decreased recurrence-free survival after CHM resection. Conclusion: Short time to recurrence after CHM resection correlates with a poor prognosis. Histological type of poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor might be a predictor for early recurrence after CHM resection.
引用
收藏
页码:368 / 375
页数:8
相关论文
共 28 条
[1]   Tumor progression while on chemotherapy - A contraindication to liver resection for multiple colorectal metastases? [J].
Adam, R ;
Pascal, G ;
Castaing, D ;
Azoulay, D ;
Delvart, V ;
Paule, B ;
Levi, F ;
Bismuth, H .
ANNALS OF SURGERY, 2004, 240 (06) :1052-1064
[2]   Trends in long-term survival following liver resection for hepatic colorectal metastases [J].
Choti, MA ;
Sitzmann, JV ;
Tiburi, MF ;
Sumetchotimetha, W ;
Rangsin, R ;
Schulick, RD ;
Lillemoe, KD ;
Yeo, CJ ;
Cameron, JL .
ANNALS OF SURGERY, 2002, 235 (06) :759-765
[3]  
COUINAUD C, 1954, J Chir (Paris), V70, P933
[4]  
COX DR, 1972, J R STAT SOC B, V34, P187
[5]   Tumor doubling tune predicts recurrence after surgery and describes the histological pattern of hepatocellular carcinoma on cirrhosis [J].
Cucchetti, A ;
Vivarelli, M ;
Piscaglia, F ;
Nardo, B ;
Montalti, R ;
Grazi, GL ;
Ravaioli, M ;
La Barba, G ;
Cavallari, A ;
Bolondi, L ;
Pinna, AD .
JOURNAL OF HEPATOLOGY, 2005, 43 (02) :310-316
[6]   Effect of steatohepatitis associated with irinotecan or oxaliplatin pretreatment on resectability of hepatic colorectal metastases [J].
Fernandez, FG ;
Ritter, J ;
Goodwin, JW ;
Linehan, DC ;
Hawkins, WG ;
Strasberg, SM .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2005, 200 (06) :845-853
[7]   Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer - Analysis of 1001 consecutive cases [J].
Fong, Y ;
Fortner, J ;
Sun, RL ;
Brennan, MF ;
Blumgart, LH .
ANNALS OF SURGERY, 1999, 230 (03) :309-318
[8]   REPEAT HEPATIC RESECTIONS FOR METASTATIC COLORECTAL-CANCER [J].
FONG, Y ;
BLUMGART, LH ;
COHEN, A ;
FORTNER, J ;
BRENNAN, MF .
ANNALS OF SURGERY, 1994, 220 (05) :657-662
[9]   Liver resection for colorectal metastases [J].
Fong, YM ;
Cohen, AM ;
Fortner, JG ;
Enker, WE ;
Turnbull, AD ;
Coit, DG ;
Marrero, AM ;
Prasad, M ;
Blumgart, LH ;
Brennan, MF .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (03) :938-946
[10]   Growth rate of pancreatic adenocarcinoma: Initial clinical experience [J].
Furukawa, H ;
Iwata, R ;
Moriyama, N .
PANCREAS, 2001, 22 (04) :366-369