title: Liver abscess after liver metastasectomy is a poor prognostic factor in patients with colorectal cancer.
abstract: OBJECTIVE
  More and more complications of extensive hepatic resection are being encountered in patients treated for liver metastases from colorectal cancer. This study aimed to determine the impact of liver abscess after hepatic resection on overall survival (OS) and the role of adjuvant chemotherapy.
  
  
  METHODS
  This is a retrospective study of 252 patients treated by liver metastasectomy between 2001 and 2010.
  
  
  RESULTS
  The 5-year survival rate was 55.8%. Twenty-one (8.3%) patients developed liver abscess after liver metastasectomy. Multivariate analysis identified the size of liver metastasis, surgical margin, and the presence of liver abscess as significant prognostic factors. Patients (whether or not they developed liver abscess after hepatic resection) had similar progression-free survival (median, 9.8 vs. 12.4 months, P = 0.476), but patients who developed liver abscess had significantly shorter OS (26.6 vs. 76.0 months, P = 0.004). Subsequent adjuvant therapy significantly improved OS in these patients (16.9 vs. 38.5 months, P = 0.032).
  
  
  CONCLUSIONS
  Liver abscess after liver metastasectomy is an independent prognostic factor, and adjuvant chemotherapy is warranted in those patients who develop liver abscess.
authors.affiliation: Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.
authors.forename: Yen-Ning
authors.initials: YN
authors.lastname: Hsu
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
authors.forename: Wei-Shone
authors.initials: WS
authors.lastname: Chen
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Lin
authors.forename: Shung-Haur
authors.initials: SH
authors.lastname: Yang
authors.forename: Jeng-Kai
authors.initials: JK
authors.lastname: Jiang
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Chang
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Lin
authors.forename: Chueh-Chuan
authors.initials: CC
authors.lastname: Yen
authors.forename: Jin-Huang
authors.initials: JH
authors.lastname: Liu
authors.forename: Cheng-Hwai
authors.initials: CH
authors.lastname: Tzeng
authors.forename: Hao-Wei
authors.initials: HW
authors.lastname: Teng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008100:Liver Abscess / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate