title: Predictors of early recurrence after resection of colorectal liver metastases.
abstract: BACKGROUND
  Early recurrence after resection of colorectal liver metastases (CLM) is common. Patients at risk of early recurrence may be candidates for enhanced preoperative staging and/or earlier postoperative imaging. The aim of this study was to determine if there are any risk factors that specifically predict early liver-only and systemic recurrence.
  
  
  METHODS
  Retrospective analysis of prospective database of patients undergoing liver resection (LR) for CLM from 2004 to 2006 was undertaken. Early recurrence was defined as occurring within 18 months of LR. Patients were classified into three groups: early liver-only recurrence, early systemic recurrence and recurrence-free. Preoperative factors were compared between patients with and without early recurrence.
  
  
  RESULTS
  Two hundred and forty-three consecutive patients underwent LR for CLM. Twenty-seven patients (11%) developed early liver-only recurrence. Dukes C stage and male sex were significantly associated with early liver-only recurrence (P < 0.05). Sixty-six patients (27%) developed early systemic recurrence. Tumour size ≥3.6 cm and tumour number (>2) were significantly associated with early systemic recurrence (P < 0.001).
  
  
  CONCLUSIONS
  It is possible to stratify patients according to the risk of early liver-only or systemic recurrence after resection of CLM. High-risk patients may be candidates for preoperative MRI and/or computed tomography-positron emission tomography (CT-PET) scan and should receive intensive postoperative surveillance.
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. balsin@hotmail.com.|Centre for Liver Research, Institute for Biomedical Research, The Medical School, University of Birmingham, Edgbaston, Birmingham, West Midlands, B15 2TT, UK. balsin@hotmail.com.
authors.forename: Ricky Harminder
authors.initials: RH
authors.lastname: Bhogal
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. j.hodson@uhb.nhs.uk.
authors.forename: James
authors.initials: J
authors.lastname: Hodson
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. s.bramhall@uhb.nhs.uk.
authors.forename: Simon Roderick
authors.initials: SR
authors.lastname: Bramhall
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. j.isaac@uhb.nhs.uk.
authors.forename: John
authors.initials: J
authors.lastname: Isaac
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. r.marudanayagam@uhb.nhs.uk.
authors.forename: Ravi
authors.initials: R
authors.lastname: Marudanayagam
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. d.f.mirza@uhb.nhs.uk.
authors.forename: Darius Feroze
authors.initials: DF
authors.lastname: Mirza
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. p.muiesan@uhb.nhs.uk.
authors.forename: Paolo
authors.initials: P
authors.lastname: Muiesan
authors.affiliation: University Hospitals of Birmingham, Metchley Lane, Birmingham, West Midlands, B15 2TT, UK. robert.sutcliffe@uhb.nhs.uk.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Sutcliffe
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors