Abstract
Recurrence of metastatic disease after resection of liver metastases from colorectal cancer remains a major problem as 70–80 % of patients will have a recurrence, most commonly in the liver or lung. To predict patterns of recurrence and outcome may guide follow-up and further treatment, as patients with recurrence might be candidates for repeated surgery or ablation therapy. A summary of studies shows that after hepatectomy 20–43 % will have a recurrence only in the remaining liver without extrahepatic disease, whereas 15–37 % will have a recurrence only to the lung. Early recurrence is associated with poorer outcome compared to late recurrence. Site of first recurrence after resection of liver metastases is predicted by several baseline variables; synchronous disease, primary tumor site, hepatic tumor size, CEA level, number of hepatic lesions, and RAS mutation status. Pattern of recurrence is a predictor for survival after hepatectomy, with liver-only and lung-only recurrences having the best survival. In the majority of patients with isolated hepatic or lung recurrence, repeated metastasectomy is possible resulting in a 40 % 5-year survival rate. Perioperative chemotherapy reduces the risk of liver recurrence after hepatectomy of colorectal cancer liver metastases.
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References
Adair RA, Young AL, Cockbain AJ et al (2012) Repeat hepatic resection for colorectal liver metastases. Br J Surg 99:1278–1283
Andreou A, Kopetz S, Maru DM et al (2012) Adjuvant chemotherapy with FOLFOX for primary colorectal cancer is associated with increased somatic gene mutations and inferior survival in patients undergoing hepatectomy for metachronous liver metastases. Ann Surg 256:642–650
Assumpcao L, Choti MA, Gleisner AL et al (2008) Patterns of recurrence following liver resection for colorectal metastases: effect of primary rectal tumor site. Arch Surg 143:743–749
Butte JM, Gonen M, Ding P et al (2012) Patterns of failure in patients with early onset (synchronous) resectable liver metastases from rectal cancer. Cancer 118:5414–5423
D’Angelica M, Kornprat P, Gonen M et al (2011) Effect on outcome of recurrence patterns after hepatectomy for colorectal metastases. Ann Surg Oncol 18:1096–1103
de Jong MC, Pulitano C, Ribero D et al (2009) Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1,669 patients. Ann Surg 250:440–448
Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–946
Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318
Grossmann I, Doornbos PM, Klaase JM et al (2014) Changing patterns of recurrent disease in colorectal cancer. Eur J Surg Oncol 40:234–239
Hill CR, Chagpar RB, Callender GG et al (2012) Recurrence following hepatectomy for metastatic colorectal cancer: development of a model that predicts patterns of recurrence and survival. Ann Surg Oncol 19:139–144
Hirokawa F, Hayashi M, Miyamoto Y et al (2014) Reconsideration of the indications for adjuvant chemotherapy for liver metastases from colorectal cancer after initial hepatectomy. Ann Surg Oncol 21:139–146
Hughes ES, Cuthbertson AM (1962) Recurrence after curative excision of carcinoma of the large bowel. JAMA 182:1303–1306
Inoue M, Ohta M, Iuchi K et al (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78:238–244
Isella C, Mellano A, Galimi F et al (2013) MACC1 mRNA levels predict cancer recurrence after resection of colorectal cancer liver metastases. Ann Surg 257:1089–1095
Ito H, Mo Q, Qin LX, Viale A et al (2013) Gene expression profiles accurately predict outcome following liver resection in patients with metastatic colorectal cancer. PLoS One (E pub 10 Dec 2013)
Karagkounis G, Torbenson MS, Daniel HD et al (2013) Incidence and prognostic impact of KRAS and BRAF mutation in patients undergoing liver surgery for colorectal metastases. Cancer 119:4137–4144
Karanjia ND, Lordan JT, Fawcett WJ et al (2009) Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases: a ten year study. Eur J Surg Oncol 35:838–843
Kato T, Yasui K, Hirai T et al (2003) Therapeutic results for hepatic metastasis of colorectal cancer with special reference to effectiveness of hepatectomy: analysis of prognostic factors for 763 cases recorded at 18 institutions. Dis Colon Rectum 46:S22–S31
Kim MJ, Lee HS, Kim JH et al (2012) Different metastatic pattern according to the KRAS mutational status and site-specific discordance of KRAS status in patients with colorectal cancer. BMC Cancer 12:347
Kopetz S, Chang GJ, Overman MJ et al (2009) Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol 27:3677–3683
Kulik U, Bektas H, Klempnauer J, Lehner F (2013) Repeat liver resection for colorectal metastases. Br J Surg 100:926–932
Lee H, Choi DW, Cho YB, et al (2014) Recurrence pattern depends on the location of colon cancer in the patients with synchronous colorectal liver metastasis. Ann Surg Oncol (E pub 5 Feb 2014)
Maithel SK, Gönen M, Ito H et al (2012) Improving the clinical risk score: an analysis of molecular biomarkers in the era of modern chemotherapy for resectable hepatic colorectal cancer metastases. Surgery 151:162–170
Malik HZ, Gomez D, Wong V et al (2007) Predictors of early disease recurrence following hepatic resection for colorectal cancer metastasis. Eur J Surg Oncol 33:1003–1009
Mise Y, Imamura H, Hashimoto T et al (2010) Cohort study of the survival benefit of resection for recurrent hepatic and/or pulmonary metastases after primary hepatectomy for colorectal metastases. Ann Surg 251:902–909
Mitry E, Guiu B, Cosconea S et al (2010) Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study. Gut 59:1383–1388
Nash GM, Gimbel M, Shia J et al (2010) KRAS mutation correlates with accelerated metastatic progression in patients with colorectal liver metastases. Ann Surg Oncol 17:572–578
Nordholm-Carstensen A, Krarup PM, Jorgensen LN et al (2014) Danish colorectal cancer group. Occurrence and survival of synchronous pulmonary metastases in colorectal cancer: a nationwide cohort study. Eur J Cancer 50:447–456
Nordlinger B, Guiguet M, Vaillant JC et al (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1,568 patients. Cancer 77:1254–1262
Nordlinger B, Sorbye H, Glimelius B et al (2008) Preoperative chemotherapy with FOLFOX4 and surgery for resectable liver metastases form colorectal cancer. Lancet 371:1007–1016
Nordlinger B, Sorbye H, Glimelius B et al (2013) Perioperative FOLFOX4 chemotherapy and surgery for resectable liver metastases from colorectal cancer: long-term survival results of the EORTC Intergroup phase III study 40983. Lancet Oncol 14:1208–1215
Pawlik TM, Scoggins CR, Zorzi D et al (2005) Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg 241:715–722
Rees M, Tekkis PP, Welsh FK et al (2008) Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg 247:125–135
Saiura A, Yamamoto J, Hasegawa K et al (2012) Liver resection for multiple colorectal liver metastases with surgery up-front approach: bi-institutional analysis of 736 consecutive cases. World J Surg 36:2171–2178
Siegel RL, Ward EM, Jemal A et al (2012) Trends in colorectal cancer incidence rates in the United States by tumor location and stage, 1992–2008. Cancer Epidemiol Biomark Prev 21:411–416
Sorbye H, Kohne CH, Sargent D, Glimelius B (2007) Patient characteristics and stratification in medical treatment studies for metastatic colorectal cancer. Ann Oncol 18:1666–1672
Sorbye H, Mauer M, Gruenberger T et al (2012) Predictive factors for the benefit of peri-operative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983). Ann Surg 255:534–539
Stremitzer S, Stift J, Gruenberger B et al (2012) KRAS status and outcome of liver resection after neoadjuvant chemotherapy including bevacizumab. Br J Surg 99:1575–1582
Tanis E, Nordlinger B, Mauer M et al (2014) Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983. Eur J Cancer (E pub 7 Jan 2014)
Tie J, Lipton L, Desai J et al (2011) KRAS mutation is associated with lung metastasis in patients with curatively resected colorectal cancer. Clin Cancer Res 17:1122–1130
Tran B, Kopetz S, Tie J et al (2011) Impact of BRAF mutation and microsatellite instability on the pattern of metastatic spread and prognosis in metastatic colorectal cancer. Cancer 117:4623–4632
Vauthey JN, Zimmitti G, Kopetz SE et al (2013) RAS mutation status predicts survival and patterns of recurrence in patients undergoing hepatectomy for colorectal liver metastases. Ann Surg 258:619–626
Wicherts DA, de Haas RJ, Salloum C et al (2013) Repeat hepatectomy for recurrent colorectal metastases. Br J Surg 100:808–818
Yopp AC, Shia J, Butte JM et al (2012) CXCR4 expression predicts patient outcome and recurrence patterns after hepatic resection for colorectal liver metastases. Ann Surg Oncol 19(Suppl 3):S339–S346
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Sorbye, H. (2014). Recurrence Patterns After Resection of Liver Metastases from Colorectal Cancer. In: Otto, F., Lutz, M. (eds) Early Gastrointestinal Cancers II: Rectal Cancer. Recent Results in Cancer Research, vol 203. Springer, Cham. https://doi.org/10.1007/978-3-319-08060-4_17
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DOI: https://doi.org/10.1007/978-3-319-08060-4_17
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