title: Survival outcomes of liver metastasectomy in colorectal cancer cases: a single-center analysis in Turkey.
abstract: BACKGROUND
  The purpose of this study was to analyze our series of liver resections for metastatic colorectal carcinoma (mCRC) to determine prognostic factors affecting survival and to evaluate the potential roles of neoadjuvant or adjuvant chemotherapy.
  
  
  METHODS
  Ninety-nine patients who underwent metastasectomy for liver metastases due to colorectal cancer at the Department of Medical Oncology, 9 Eylul University Hospital between 1996 and 2010 were evaluated in this study. The patients were followed through July 2013. Demographic, perioperative, laboratory, radiological and chemotherapy as well as survival data were obtained by retrospective chart review.
  
  
  RESULTS
  In 47 (47.5%) patients, liver metastases were unresectable at initial evaluation; the remaining 52 (52.5%) patients exhibited resectable liver metastases. Simultaneous hepatic resection was applied to 52 (35.4%) patients with synchronous metastasis, whereas 5 (64.5%) patients underwent hepatic resection after neoadjuvant chemotherapy. Forty-two patients with metachronous metastasis underwent hepatic resection following neoadjuvant chemotherapy. R0 resection was obtained in 79 (79.8%) patients. A second hepatectomy was performed in 22 (23.2%) patients. Adjuvant chemotherapy was given to 85 (85.9%) patients after metastasectomy. The median disease-free and overall survivals after initial metastasectomy were 12 and 37 months, respectively, the 1-year, 3-year and 5-year disease-free survival (DFS) and overall survival (OS) rates being 46.5%, 24.3% and 17.9%and 92.3%, 59.0% and 39.0%, respectively. On multivariate analysis, the primary tumor site, tumor differentiation, resection margin and DFS were independent factors predicting better overall survival.
  
  
  CONCLUSIONS
  In selected cases, hepatic metastasectomy for mCRC to the liver can result in long-term survival. Neoadjuvant chemotherapy did not exert a positive effect on DFS or OS. Adjuvant chemotherapy also did not appear to impact DFS and OS.
authors.affiliation: Department of Basic Oncology, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey E-mail : demir.lutfiye77@gmail.com.
authors.forename: Suna
authors.initials: S
authors.lastname: Cokmert
authors.forename: Hulya
authors.initials: H
authors.lastname: Ellidokuz
authors.forename: Lutfiye
authors.initials: L
authors.lastname: Demir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Fuzun
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Astarcioglu
authors.forename: Deniz
authors.initials: D
authors.lastname: Aslan
authors.forename: Ugur
authors.initials: U
authors.lastname: Yilmaz
authors.forename: Ilhan
authors.initials: I
authors.lastname: Oztop
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008297:Male; D059146:Metastasectomy / Q000401:mortality*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D014421:Turkey