Ninety-six five-year survivors after liver resection for metastatic colorectal cancer.
BACKGROUND
Studies have consistently confirmed the benefit of liver resection for metastatic colorectal cancer. Few reports, however, have a long enough followup or sufficient 5-year survivors to study the clinical course of patients beyond 5 years.


METHODS
From July 1985 through December 1991, 456 patients underwent liver resection for colorectal metastases. Ninety-six actual 5-year survivors (21%) were identified and their clinical course retrospectively reviewed.


RESULTS
Five-year survivors (n = 96) were more likely to have a Duke's B primary colorectal carcinoma, fewer than four metastatic lesions, unilobar disease, and a negative histologic margin when compared with patients not surviving 5 years (n = 298). Forty-four (46%) of the 96 five-year survivors had a recurrence after hepatectomy. Of these 44, 19 (43%) were rendered disease free after further treatment. Overall, 71 of the 96 five-year survivors were free of disease at last followup. The actuarial 10-year survival of this group was 78%.


CONCLUSIONS
Patients that are disease free 5 years after liver resection are likely to have been cured by liver resection. Patients should be aggressively followed for recurrence because of the potential for further treatment and longterm survival.
D'Angelica
M
M
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Brennan
M F
MF
Fortner
J G
JG
Cohen
A M
AM
Blumgart
L H
LH
Fong
Y
Y
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*