Tumor recurrence and options for further treatment after resection of liver metastases in patients with colorectal cancer.
The aim of this study was to evaluate the pattern of recurrence and its impact on therapy in patients undergoing liver resection for colorectal metastases. Within 7 years 105 patients were operated on; 75 patients were followed up for at least 2 years postoperatively with a median follow-up of 30 months (range 24-93 months). The median time interval when patients were free of tumor recurrence was only 9 months. The initial recurrence site was the liver in 47% and the other sites were extrahepatic in 39%. Seventy-one percent of the patients developed disseminated metastases as the disease progressed. The median survival time after diagnosis of tumor recurrence was 14 months and was significantly affected by the type of treatment used for the recurrence. Surgical resection was followed by a 23-month median survival, while systemic and intra-arterial chemotherapy led to a 14- and 15-month median survival time, respectively. Untreated patients had a median survival of only 4 months. It is concluded that liver resection for colorectal secondaries leads to a very limited number of disease-free survivors after 5 years. As a few patients may profit from a surgical treatment even in cases of recurrence, surgery should not be regarded as useless.
Hohenberger
P
P
Department of Surgery, University of Heidelberg, Federal Republic of Germany.
Schlag
P
P
Schwarz
V
V
Herfarth
C
C
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012008:Recurrence; D012086:Reoperation; D015996:Survival Rate