This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Predictors of extrahepatic recurrence after resection of colorectal liver metastases. BJS 2004; 91: 327-333.
Published: 18th December 2003
Authors: H. Ueno, H. Mochizuki, Y. Hashiguchi, K. Hatsuse, H. Fujimoto, K. Hase et al.
Background
It is important to identify patients at high risk of extrahepatic recurrence after surgery for liver metastases, in order to maximize the survival benefit obtained by prophylactic regional chemotherapy.
Method
Data from 68 patients who underwent resection of colorectal liver metastases but who did not receive hepatic arterial chemotherapy or intravenous systemic chemotherapy were collected. Twenty‐two variables were examined by univariate and multivariate analyses to determine which factors were relevant to extrahepatic recurrence. A scoring system was developed that included the most relevant factors.
Results
The extrahepatic recurrence rate at 3 years after hepatectomy was 57·8 per cent. Three variables were independently associated with extrahepatic recurrence including raised serum level of carcinoembryonic antigen after hepatectomy (relative risk (RR) 5·4, P < 0·001), venous invasion of the primary tumour (RR 4·0, P = 0·001) and high‐grade budding of the primary tumour (RR 3·1, P = 0·006). Patients with none of these risk factors had a 3‐year extrahepatic recurrence rate of 7·1 per cent, compared with 61·6 per cent for those with one risk factor and 100 per cent for those with two or three risk factors.
Conclusion
It was possible to identify patients at high risk of disease relapse at extrahepatic sites. This system might be used on an individual basis to select patients with colorectal liver metastases for regional chemotherapy or systemic chemotherapy after surgical intervention. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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