title: Predicting early intrahepatic recurrence after curative resection of colorectal liver metastases with molecular markers.
abstract: BACKGROUND
  The aim of this case-control study was to identify clinicopathological factors and test three relevant biomarkers for their ability to predict early intrahepatic recurrence after curative liver resection for colorectal liver metastases (CLM).
  
  
  METHODS
  Of the 184 patients with CLM undergoing hepatectomy between January 2007 and December 2009, thirty patients had intrahepatic disease recurrence within 6 months. The control group was randomly selected from a cohort of patients between April 1997 and December 2005 who have survived without disease recurrence after CLM resection for over 5 years. Both groups were matched for size of metastasis greater than 5.0 cm, the presence of multiple metastases, and synchronous versus metachronous CLM. The final study population consisted of 60 patients with CLM undergoing R0 hepatectomy, 30 of whom had early intrahepatic-only recurrences (study group) and 30 patients without recurrence for more than 5 years (control group). Both groups were analyzed and compared for the presence of clinical factors and expression levels of CD133, survivin, and Bcl-2 within tumor tissue.
  
  
  RESULTS
  Characteristics of patients were similar between the two groups except primary tumor location and administration of postoperative chemotherapy. Expression level of CD133 and survivin were significantly increased in tumors of patients with recurrence compared to patients without recurrence. On multivariate analysis high tumor expression levels of CD133 (odds ratio [OR] 14.7, confidence interval [CI] 1.8-121.3, p = 0.012) and survivin (OR 9.5, CI 2.1-44.3, p = 0.004) and postoperative chemotherapy (OR 4.8, CI 1.01-22.9, p = 0.049) were independent factors associated with early intrahepatic recurrence.
  
  
  CONCLUSIONS
  Tumor expression levels of CD133 and survivin may be a useful predictor of early intrahepatic recurrence after hepatectomy for CLM. Administration of postoperative chemotherapy may prevent early intrahepatic recurrence.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67098, Strasbourg Cedex, France, narinari@kuhp.kyoto-u.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Chenard
authors.forename: Pascal
authors.initials: P
authors.lastname: Fuchshuber
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
mesh_terms: D000071916:AC133 Antigen; D015703:Antigens, CD / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D017115:Catheter Ablation; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006023:Glycoproteins / Q000032:analysis*; D006498:Hepatectomy; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D008113:Liver Neoplasms / Q000737:chemistry* / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000737:chemistry*; D010455:Peptides / Q000032:analysis*; D011237:Predictive Value of Tests; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D012372:ROC Curve; D012189:Retrospective Studies; D000077022:Survivin
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D006023:Glycoproteins; D051034:Inhibitor of Apoptosis Proteins; C000606023:PROM1 protein, human; D010455:Peptides; D019253:Proto-Oncogene Proteins c-bcl-2; D000077022:Survivin