title: [Risk factor analysis of early recurrence after resection of colorectal liver metastasis].
abstract: OBJECTIVE
  To explore the role of repeat liver resection in colorectal liver metastasis (CRLM) with early recurrence and to analyze the risk factors of early recurrence.
  
  
  METHODS
  Clinicopathological and follow-up data of 303 CRLM patients undergoing liver resection in our department between January 2000 and August 2014 were analyzed retrospectively. The 5-year overall survivals between early recurrence(within postoperative 1 year) and non-early recurrence were compared. The impact of repeat liver resection on 5-year survival of early recurrence was analyzed. Clinicopathological features which might be associated with early recurrence were investigated using univariate and multivariate analyses.
  
  
  RESULTS
  Among 303 patients, 192(63.4%) patients had recurrence, including 145 patients of early recurrence and 47 of non-early recurrence. The 5-year overall survival of early recurrence patients was significantly lower compared with non-early recurrence ones(16.0% vs. 63.9%, P=0.000). Among 145 early recurrence patients, 80 were evaluated as resectable, of whom 22 received repeat liver resection. Compared with other 58 patients receiving conservative treatment, above 22 patients receiving repeat liver resection had a significantly higher 5-year overall survival(27.1% vs. 0%, P=0.033). Multivariate analysis revealed T-stage of primary tumor, lymph node metastasis, and larger size(> 5 cm) of metastatic liver focus were independent risk factors of early recurrence, and good efficacy of neo-adjuvant chemotherapy was independent protective factor of early recurrence(all P<0.05). Repeat liver resection was associated with better long-term survival.
  
  
  CONCLUSIONS
  The prognosis of early recurrence after liver resection in CRLM patients is poor, while repeat resection for resectable lesions in recurrence patients can obviously prolong the survival. For those with late T-stage, lymph node metastasis, and larger metastatic liver focus, actively preoperative neo-adjuvant chemotherapy should be considered.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department One of Hepatopancreaticobiliary Surgery, Peking University Cancer Hospital and Institute, Beijing 10042, China. xingbaocai88@sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Xiaoluan
authors.initials: X
authors.lastname: Yan
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Bao
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.forename: Hongwei
authors.initials: H
authors.lastname: Wang
authors.forename: Kemin
authors.initials: K
authors.lastname: Jin
authors.forename: Baocai
authors.initials: B
authors.lastname: Xing
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D005163:Factor Analysis, Statistical; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate