title: Predictors for early recurrence after hepatectomy for initially unresectable colorectal liver metastasis.
abstract: BACKGROUND
  Early recurrence correlates with poor survival following various cancer surgeries and puts considerable stress on patients both physically and mentally. This retrospective study investigated the predictive factors for early recurrence after surgical resection for initially unresectable colorectal liver metastasis to elucidate indications for conversion strategies.
  
  
  METHODS
  We retrospectively studied 46 patients who underwent hepatectomy after chemotherapy for initially unresectable colorectal liver metastasis from 1997 to 2010.
  
  
  RESULTS
  Recurrences occurred within 6 months after hepatectomy in 13 patients (37 %). The median survival time of 21.2 months and the 5-year survival rate of 0 % after hepatectomy in patients with recurrence within 6 months were significantly worse than those in patients with recurrence more than 6 months after hepatectomy. Recurrence in less than 6 months was significantly correlated with impossibility of anticancer therapy for recurrence after hepatectomy (p = 0.01). Eight or more hepatic tumors after chemotherapy were the only predictor of recurrence within 6 months (p = 0.01; odds ratio 9.6; 95 % confidence interval 1.5-60.6).
  
  
  CONCLUSIONS
  Recurrence within 6 months was significantly correlated with a poorer outcome following surgery for initially unresectable colorectal liver metastasis. Surgical indication for initially unresectable colorectal liver metastasis with eight or more hepatic tumors after chemotherapy should be considered carefully in the light of mental and physical status, co-morbidity, and alternative treatment plans.
authors: Department of Hepato-biliary Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan. shtakaha@east.ncc.go.jp
authors: Shinichiro
authors: S
authors: Takahashi
authors: Masaru
authors: M
authors: Konishi
authors: Takahiro
authors: T
authors: Kinoshita
authors: Naoto
authors: N
authors: Gotohda
authors: Yuichiro
authors: Y
authors: Kato
authors: Norio
authors: N
authors: Saito
authors: Masanori
authors: M
authors: Sugito
authors: Takayuki
authors: T
authors: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
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