Chance of cure following liver resection for initially unresectable colorectal metastases: analysis of actual 5-year survival

Francesco Ardito, Maria Vellone, Alessandra Cassano, Gennaro Nuzzo, Felice Giuliante, Agostino Maria De Rose, Carmelo Pozzo, Alessandro Coppola, Bruno Federico, Ivo Giovannini, Carlo Antonio Barone

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

21 Citazioni (Scopus)

Abstract

Background Survival with long-term follow-up following liver resection for unresectable colorectal liver metastases (CRLM) downsized by chemotherapy has rarely been reported. The aim of this study was to determine the chance of cure following liver resection for initially unresectable CRLM. Methods Between January 2000 and December 2009, 61 patients underwent hepatectomy for unresectable liver-only CRLM downsized after chemotherapy. Cure was defined as a recurrence-free interval of at least 5 years after primary hepatectomy. Results Resectability of CRLM was achieved after a mean number of 11 courses, and 42.6 % of patients underwent liver resection after ≥10 courses. Postoperative mortality was nil, and morbidity rate was 19.7 %. The 5- and 10-year actuarial overall survival rates were 42.6 and 16.0 %. Of 30 patients with a follow-up ≥5 years, 11 were alive, yielding a 5-year actual overall survival rate of 36.7 %, and 7 (23.3 %) were considered cured because they are alive without recurrence. On multivariate analysis, response to chemotherapy was the only independent predictor of both overall and disease-free survival. Conclusions Cure can be achieved in about 23 % of patients resected for initially unresectable CRLM downsized by chemotherapy. Liver resection can be safely performed in selected patients even after multiple courses of chemotherapy.
Lingua originaleEnglish
pagine (da-a)352-359
Numero di pagine8
RivistaJournal of Gastrointestinal Surgery
Volume17
DOI
Stato di pubblicazionePubblicato - 2013

Keywords

  • Actual survival
  • Cure
  • Downsized liver metastases
  • Liver resection
  • Unresectable colorectal liver metastases

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