scholarly journals Prognostic Factors Affecting Survival of Patients after Liver Resection Due to Colorectal Liver Metastases

2016 ◽  
Vol 70 (3) ◽  
pp. 133-139
Author(s):  
Stefan Petrovski ◽  
Elena Arabadzhieva ◽  
Saso Bonev ◽  
Dimitar Bulanov ◽  
Valentin Popov ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Prognostic Significance ◽  
Radical Resection ◽  
University Hospital ◽  
Tumor Type ◽  
Term Survival ◽  
Localization Of Metastases

Abstract Introduction. Colorectal liver metastases have a poor prognosis and only 2% have an average 5-year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%. Aim. To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients. Methods. A retrospective study was conducted at the Clinic of General and Hepato-pancreatic Surgery at the University Hospital “Aleksandrovska”-Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS-19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT). Results. Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni-or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients. Conclusion. In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival.

scholarly journals Postoperative CEA is a better prognostic marker than CA19-9, hCGβ or TATI after resection of colorectal liver metastases

Tumor Biology ◽  
2018 ◽  
Vol 40 (1) ◽  
pp. 101042831775294 ◽  
Author(s):  
Reetta Peltonen ◽  
Pia Österlund ◽  
Marko Lempinen ◽  
Arno Nordin ◽  
Ulf-Håkan Stenman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Resection ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Prognostic Marker ◽  
Colorectal Liver Metastases ◽  
Prognostic Significance ◽  
University Hospital ◽  
Colorectal Cancer Patients

Liver metastases of colorectal cancer can be operated with a curative intent in selected cases. However, more than half of the patients have a recurrence. The aim of this study was to evaluate the prognostic and predictive value of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), human chorionic gonadotropin β (hCGβ) and tumour-associated trypsin-inhibitor (TATI) in colorectal cancer patients before and 3 months after resection of liver metastases. Marker concentrations were determined in blood samples from 168 colorectal cancer patients, who underwent liver resection between the years 1998 and 2007 at Helsinki University Hospital, Finland. The samples were taken before and 3 months after curative resection. Increased concentrations of CEA (>5 µg/L) and hCGβ (>1 pmol/L) 3 months after liver resection correlated with recurrence and impaired overall survival and increased CA19-9 (>26 kU/L) with impaired overall survival, but postoperative TATI was not prognostic. Preoperatively elevated CEA and CA19-9 correlated with impaired overall survival, but not with recurrence. Neither preoperative hCGβ nor TATI was prognostic. In conclusion, CEA is a useful prognostic marker, when measured 3 months after resection of colorectal liver metastases. CA19-9 also has prognostic significance and may have additional value.

scholarly journals P-166 Re-hepatectomy is a predictor of long-term survival in patients that recur after liver resection of colorectal liver metastases

2016 ◽  
Vol 27 ◽  
pp. ii49
Author(s):  
M. Marques ◽  
H.S. de Castro Ribeiro ◽  
W.L. Costa ◽  
A.L. Diniz ◽  
A. Godoy ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

Nonresponse to pre-operative chemotherapy does not preclude long-term survival after liver resection in patients with colorectal liver metastases

Surgery ◽  
2009 ◽  
Vol 146 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Ulf P. Neumann ◽  
Armin Thelen ◽  
Christoph Röcken ◽  
Daniel Seehofer ◽  
Marcus Bahra ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Surgical Options for Initially Unresectable Colorectal Liver Metastases

HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Irinel Popescu ◽  
Sorin Tiberiu Alexandrescu
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Palliative Treatment ◽  
Survival Rates ◽  
Portal Vein Ligation ◽  
Term Survival ◽  
Number Of Patients ◽  
Unresectable Colorectal Liver Metastases ◽  
Surgical Options

Although the frontiers of liver resection for colorectal liver metastases have broadened in recent decades, approximately 75% of these patients present with unresectable metastases at the time of their diagnosis. In the past, these patients underwent only palliative treatment, without the chance of a cure. In the previous two decades, several therapeutic strategies have been developed that render resectable those metastases that were initially unresectable, thus offering the chance of long-term survival and even a cure to these patients. The oncosurgical modalities that are available include liver resection following portal vein ligation/embolization, “two-stage” liver resection, one-stage ultrasonically guided liver resection, hepatectomy following conversion chemotherapy, and liver resection combined with thermal ablation. Moreover, in recent years, certain authors have recommended the revisiting of the concept of liver transplantation in highly selected patients with unresectable colorectal liver metastases and favorable prognostic factors. By employing such therapies, the number of patients with colorectal liver metastases who undergo a potentially curative treatment could increase to 40%. The safety profile of these approaches is acceptable (morbidity rates as high as 45%, mortality rates of less than 5%). Furthermore, the 5-year survival rates (approximately 30%) are significantly increased over those that were achieved with palliative treatment.

Actual 10-Year Survival After Resection of Colorectal Liver Metastases Defines Cure

2007 ◽  
Vol 25 (29) ◽  
pp. 4575-4580 ◽  
Author(s):  
James S. Tomlinson ◽  
William R. Jarnagin ◽  
Ronald P. DeMatteo ◽  
Yuman Fong ◽  
Peter Kornprat ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Randomized Clinical Trials ◽  
Curative Intent ◽  
Term Survival ◽  
Number Of Patients ◽  
Disease Free ◽  
Disease Specific

Purpose Resection of colorectal liver metastases (CLM) in selected patients has evolved as the standard of care during the last 20 years. In the absence of prospective randomized clinical trials, a survival benefit has been deduced relative to historical controls based on actuarial data. There is now sufficient follow-up on a significant number of patients to address the curative intent of resecting CLM. Methods Retrospective review of a prospectively maintained database was performed on patients who underwent resection of CLM from 1985 to 1994. Postoperative deaths were excluded. Disease-specific survival (DSS) was calculated from the time of hepatectomy using the Kaplan-Meier method. Results There were 612 consecutive patients identified with 10-year follow-up. Median DSS was 44 months. There were 102 actual 10-year survivors. Ninety-nine (97%) of the 102 were disease free at last follow-up. Only one patient experienced a disease-specific death after 10 years of survival. In contrast, 34% of the 5-year survivors suffered a cancer-related death. Previously identified poor prognostic factors found among the 102 actual 10-year survivors included 7% synchronous disease, 36% disease-free interval less than 12 months, 25% bilobar metastases, 50% node-positive primary, 39% more than one metastasis, and 35% tumor size more than 5 cm. Conclusion Patients who survive 10 years appear to be cured of their disease, whereas approximately one third of actual 5-year survivors succumb to a cancer-related death. In well-selected patients, there is at least a one in six chance of cure after hepatectomy for CLM. The presence of poor prognostic factors does not preclude the possibility of long-term survival and cure.

HP03�LONG-TERM SURVIVAL AFTER LAPAROSCOPIC LIVER RESECTION FOR COLORECTAL LIVER METASTASES

2009 ◽  
Vol 79 ◽  
pp. A39-A39
Author(s):  
R. D. Bryant ◽  
M. Hatzifotis ◽  
I. Martin ◽  
G. Fielding ◽  
L. Nathanson ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Laparoscopic Liver Resection ◽  
Colorectal Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Prognostic Factors after Liver Resection for Colorectal Liver Metastasis

2015 ◽  
Vol 28 (3) ◽  
pp. 357 ◽  
Author(s):  
Margarida Matias ◽  
Mafalda Casa-Nova ◽  
Mariana Faria ◽  
Ricardo Pires ◽  
Joana Tato-Costa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Resection ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Regional Lymph Node ◽  
Scoring Systems ◽  
Cox Proportional Hazards Model ◽  
Prognostic Scores ◽  
Prognostic Models

<p><strong>Introduction:</strong> Surgery is the only potentially curative treatment for patients with colorectal liver metastases, resulting in 5-year survival rates of 36–58%. Although many studies have been performed to determine prognostic factors for tumor recurrence and survival after resection of colorectal liver metastases, there are few prognostic scoring systems stratifying patients undergoing surgery for colorectal liver metastases into risk group models.<br /><strong>Objectives:</strong> To identify, evaluate and compare the existing prognostic scores for survival after surgery for resection of colorectal liver metastases.<br /><strong>Material and Methods:</strong> Electronic search in PubMed, Cochrane and Embase from 1990 to 2013 using the terms ‘hepatic resection’, ‘colorectal cancer’, ‘liver metastasis’, ‘hepatectomy’, ‘prognostic’, and ‘score‘. Only studies proposing a prognostic model or risk stratification based on clinical and/or pathological variables were included.<br /><strong>Results:</strong> From 1996 to June 2013, 19 scoring systems were identified, including one nomogram. Thirty prognostic factors were identified although none of the factors was common to all prognostic models. The 4 factors most often included were: number of liver metastases, regional lymph node metastization of primary tumor, preoperative CEA level and maximum size of metastases. The median study sample size was 305 patients (81-1 568 patients) and median follow-up was 33 months (16-54 months). All studies were retrospective and used the Cox proportional hazards model for multi-variable analysis.<br /><strong>Conclusion:</strong> Several factors have been constantly reported as having prognostic value after liver resection of colorectal liver<br />metastases, although there is no consensus on the ideal scoring system.</p>

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