title: Potential of a cure in patients with colorectal liver metastases and concomitant extrahepatic disease.
abstract: OBJECTIVE
  We aimed to define the cure rate in patients with colorectal liver metastases (CRLM) and concomitant extrahepatic disease (EHD) on the 5-year disease-free survival (DFS) after surgery, and identify the factors for predicting a cure.
  
  
  METHODS
  Patients who underwent hepatectomy for CRLM with concomitant EHD were identified. Those followed for >5 years after surgery were enrolled. A cure was defined as DFS of >5 years after the last curative surgery.
  
  
  RESULTS
  A cure was achieved in 24/175 (13%) patients (intention-to-treat [ITT] cohort), and 22/109 (19%) patients who underwent complete resection for both hepatic and extrahepatic metastases (EHD resection cohort). A multivariate analysis identified primary T1-2 (relative risk [RR] 47.4, P = 0.0001), metachronous metastasis (RR 4.9, P = 0.026), carbohydrate antigen 19-9 (CA19-9) ≤37 U/mL (RR 8.37, P = 0.015), number of liver and EHD tumors (RR 11.2, P = 0.0058), and non-incidental EHD diagnosis (RR 8.41, P = 0.018) as independent factors that predicted a cure in the ITT cohort; and primary T1-2 (RR 22.2, P = 0.013), primary N0 (RR 4.42, P = 0.031), metachronous metastasis (RR 6.48, P = 0.013), and CA19-9 ≤37 U/mL (RR 27.4, P = 0.012) in the EHD resection cohort.
  
  
  CONCLUSIONS
  Even when concomitant EHD is present, a potential of cure could be achieved with aggressive oncosurgical approach.
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Inserm, Unité 935, Villejuif, France.|Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Inserm, Unité 935, Villejuif, France.|Université Paris-Sud, Villejuif, France.
authors.forename: Carlos
authors.initials: C
authors.lastname: Castro Benitez
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Inserm, Unité 935, Villejuif, France.|Université Paris-Sud, Villejuif, France.
authors.forename: Marc-Antoine
authors.initials: MA
authors.lastname: Allard
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Université Paris-Sud, Villejuif, France.|Inserm Unité 785, Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vibert
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Inserm, Unité 935, Villejuif, France.|Université Paris-Sud, Villejuif, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sa Cunha
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Université Paris-Sud, Villejuif, France.|Inserm Unité 785, Villejuif, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Université Paris-Sud, Villejuif, France.|Inserm Unité 785, Villejuif, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Castaing
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Bismuth
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.affiliation: Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.|Inserm, Unité 935, Villejuif, France.|Université Paris-Sud, Villejuif, France.
authors.forename: René
authors.initials: R
authors.lastname: Adam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis
chemical_list: D018395:CA-19-9 Antigen
keywords: colorectal liver metastasis; cure; extrahepatic disease; hepatectomy; predictive model