The prognosis of liver resection for patients with four or more colorectal liver metastases has not improved in the era of modern chemotherapy

Hokuto, Daisuke; Nomi, Takeo; Yamato, Ichiro; Yasuda, Satoshi; Obara, Shinsaku; Yoshikawa, Takahiro; Kawaguchi, Chihiro; Yamada, Takatsugu; Kanehiro, Hiromichi; Nakajima, Yoshiyuki

doi:10.1002/jso.24461

Cited by 12 publications

(9 citation statements)

References 18 publications

(26 reference statements)

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“…Although previous studies reported worse OS of RSC after liver resection for CRLM [9-12], the result focused on metachronous liver metastasis has not been reported yet. Moreover, the surgical indication and treatment strategy for CRLM were standardized in the present study [20][21][22]. Therefore, the results of the present study might be more reliable.…”

Section: Discussionmentioning

confidence: 98%

The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection

et al. 2021

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Section: Discussionmentioning

confidence: 98%

The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection

et al. 2021

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“…CEA levels ≥ 5.0 ng/mL have an adverse effect on survival that is independent of tumor stage [ 7 - 9 ]. Hokuto et al [ 10 ] reported that a serum CEA level of ≥ 20 ng/mL was one of the prognostic factors for DFS in patients with ≥ 4 colorectal liver metastases and a systematic review assessing prognostic factors for patients undergoing lung metastasectomy showed that a prethoracotomy associated elevation in CEA level was associated with poor survival [ 11 ]. In this study, elevated preoperative CEA level was identified to be an independent risk predictor for oncologic outcomes, which is consistent with the prior results in the literature.…”

Section: Discussionmentioning

confidence: 99%

Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?

et al. 2018

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PurposeThe prognosis of patientswith colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM.Materials and MethodsWe retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009.ResultsIn univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with ≤ 7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA ≤ 5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with ≤ 7 positive PALN and CEA level ≤ 5.ConclusionPALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

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“…Patient management. The operative procedure and perioperative management have been reported previously (21)(22)(23)(24). Hepatic parenchymal resection was performed with a clamp crushing technique, and an intermittent Pringle maneuver was used for almost all cases.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of Five-year Survivors After Liver Resection for Colorectal Liver Metastases in Modern Chemotherapy

et al. 2020

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Background/Aim: The aim of this study was to evaluate whether modern chemotherapy has changed characteristics of actual five-year survivors after liver resection for colorectal liver metastasis (CRLM). Patients and Methods: The records of 210 patients, who underwent curative liver resection for CRLM at our institution between January 1990 and May 2014, were reviewed. The patients treated before 2004 when modern chemotherapy was not introduced were compared with the patients treated after 2005. Results: Actual five-year survivor rates were significantly higher after 2005 (33.3% vs. 49.0%, p=0.022). Preoperative characteristics of actual five-year survivors were not different. The median survival time after nonresectable recurrence was significantly longer after 2005 (20.3 vs. 8.7 months, p=0.002). The proportion of 5-year survivors with recurrent site was significantly higher after 2005 (34.0% vs. 10.5%, p=0.019). Conclusion: Actual fiveyear survivors have increased by modern chemotherapy. However, approximately one-third of them were not cured.

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The prognosis of liver resection for patients with four or more colorectal liver metastases has not improved in the era of modern chemotherapy

Abstract: The prognosis of patients with ≥4 CRLM that undergo liver resection has not improved despite the development of modern chemotherapies. J. Surg. Oncol. 2016;114:959-965. © 2016 Wiley Periodicals, Inc.

Cited by 12 publications

References 18 publications

The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection

The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection

Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?

Characteristics of Five-year Survivors After Liver Resection for Colorectal Liver Metastases in Modern Chemotherapy

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