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Open Access 01-12-2015 | Research

Predictors of early recurrence after resection of colorectal liver metastases

Authors: Ricky Harminder Bhogal, James Hodson, Simon Roderick Bramhall, John Isaac, Ravi Marudanayagam, Darius Feroze Mirza, Paolo Muiesan, Robert Peter Sutcliffe

Published in: World Journal of Surgical Oncology | Issue 1/2015

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.

Wiering B, Vogel WV, Ruers TJ, Oyen WJ. Controversies in the management of colorectal liver metastases: role of PET and PET/CT. Dig Surg. 2008;25(6):413–20.CrossRefPubMed

Mitry E, Guiu B, Cosconea S, Jooste V, Faivre J, Bouvier AM. Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study. Gut. 2010;59(10):1383–8.CrossRefPubMed

Abdalla EK. Resection of colorectal liver metastases. J Gastrointest Surg. 2011;15(3):416–9.CrossRefPubMed

Villeneuve PJ, Sundaresan RS. Surgical management of colorectal lung metastasis. Clin Colon Rectal Surg. 2009;22(4):233–41.CrossRefPubMedCentralPubMed

Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–18. discussion 18–21.CrossRefPubMedCentralPubMed

Bradley AL, Chapman WC, Wright JK, Marsh JW, Geevarghese S, Blair KT, et al. Surgical experience with hepatic colorectal metastasis. Am Surg. 1999;65(6):560–6. discussion 6–7.PubMed

Sugihara K, Hojo K, Moriya Y, Yamasaki S, Kosuge T, Takayama T. Pattern of recurrence after hepatic resection for colorectal metastases. Br J Surg. 1993;80(8):1032–5.CrossRefPubMed

Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history. Br J Surg. 1990;77(11):1241–6.CrossRefPubMed

Goya T, Miyazawa N, Kondo H, Tsuchiya R, Naruke T, Suemasu K. Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up. Cancer. 1989;64(7):1418–21.CrossRefPubMed

10.

McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases. 10-year results. Arch Surg. 1992;127(12):1403–6.CrossRefPubMed

11.

Welter S, Jacobs J, Krbek T, Krebs B, Stamatis G. Long-term survival after repeated resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg. 2007;84(1):203–10.CrossRefPubMed

12.

The International Registry of Lung Metastases. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113(1):37–49.CrossRef

13.

Malik HZ, Gomez D, Wong V, Al-Mukthar A, Toogood GJ, Lodge JP, et al. Predictors of early disease recurrence following hepatic resection for colorectal cancer metastasis. Eur J Surg Oncol. 2007;33(8):1003–9.CrossRefPubMed

14.

Niekel MC, Bipat S, Stoker J. Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology. 2010;257(3):674–84.CrossRefPubMed

15.

Floriani I, Torri V, Rulli E, Garavaglia D, Compagnoni A, Salvolini L, et al. Performance of imaging modalities in diagnosis of liver metastases from colorectal cancer: a systematic review and meta-analysis. J Magn Reson Imaging. 2010;31(1):19–31.CrossRefPubMed

16.

Knowles B, Welsh FK, Chandrakumaran K, John TG, Rees M. Detailed liver-specific imaging prior to pre-operative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for a repeat hepatectomy. HPB (Oxford). 2012;14(5):298–309.CrossRef

17.

Kinkel K, Lu Y, Both M, Warren RS, Thoeni RF. Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): a meta-analysis. Radiology. 2002;224(3):748–56.CrossRefPubMed

18.

Brachet D, Lermite E, Rouquette A, Lorimier G, Hamy A, Arnaud JP. Prognostic factors of survival in repeat liver resection for recurrent colorectal metastases: review of sixty-two cases treated at a single institution. Dis Colon Rectum. 2009;52(3):475–83.CrossRefPubMed

19.

Vigano L, Capussotti L, Lapointe R, Barroso E, Hubert C, Giuliante F, et al. Early recurrence after liver resection for colorectal metastases: risk factors, prognosis, and treatment. A LiverMetSurvey-based study of 6,025 patients. Ann Surg Oncol. 2014;21(4):1276–86.CrossRefPubMed

20.

Neeff H, Horth W, Makowiec F, Fischer E, Imdahl A, Hopt UT, et al. Outcome after resection of hepatic and pulmonary metastases of colorectal cancer. J Gastrointest Surg. 2009;13(10):1813–20.CrossRefPubMed

21.

Shah SA, Haddad R, Al-Sukhni W, Kim RD, Greig PD, Grant DR, et al. Surgical resection of hepatic and pulmonary metastases from colorectal carcinoma. J Am Coll Surg. 2006;202(3):468–75.CrossRefPubMed

22.

Headrick JR, Miller DL, Nagorney DM, Allen MS, Deschamps C, Trastek VF, et al. Surgical treatment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg. 2001;71(3):975–9. discussion 9–80.CrossRefPubMed

23.

Khalil HI, Patterson SA, Panicek DM. Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiology. 2005;235(3):872–8.CrossRefPubMed

24.

Seo HJ, Kim MJ, Lee JD, Chung WS, Kim YE. Gadoxetate disodium-enhanced magnetic resonance imaging versus contrast-enhanced 18 F-fluorodeoxyglucose positron emission tomography/computed tomography for the detection of colorectal liver metastases. Invest Radiol. 2011;46(9):548–55.CrossRefPubMed

25.

Donati OF, Reiner CS, Hany TF, Fornaro J, von Schulthess GK, Marincek B, et al. 18 F-FDG-PET and MRI in patients with malignancies of the liver and pancreas. Accuracy of retrospective multimodality image registration by using the CT-component of PET/CT. Nuklearmedizin. 2010;49(3):106–14.CrossRefPubMed

26.

Frankel TL, Gian RK, Jarnagin WR. Preoperative imaging for hepatic resection of colorectal cancer metastasis. J Gastrointest Oncol. 2012;3(1):11–8.PubMedCentralPubMed

27.

Marsman HA, van der Pool AE, Verheij J, Padmos J, Ten Kate FJ, Dwarkasing RS, et al. Hepatic steatosis assessment with CT or MRI in patients with colorectal liver metastases after neoadjuvant chemotherapy. J Surg Oncol. 2011;104(1):10–6.CrossRefPubMed

28.

Adam R, Pascal G, Azoulay D, Tanaka K, Castaing D, Bismuth H. Liver resection for colorectal metastases: the third hepatectomy. Ann Surg. 2003;238(6):871–83. discussion 83–4.CrossRefPubMedCentralPubMed

29.

Pessaux P, Lermite E, Brehant O, Tuech JJ, Lorimier G, Arnaud JP. Repeat hepatectomy for recurrent colorectal liver metastases. J Surg Oncol. 2006;93(1):1–7.CrossRefPubMed

30.

Thelen A, Jonas S, Benckert C, Schumacher G, Lopez-Hanninen E, Rudolph B, et al. Repeat liver resection for recurrent liver metastases from colorectal cancer. Eur J Surg Oncol. 2007;33(3):324–8.CrossRefPubMed

31.

John SK, Robinson SM, Rehman S, Harrison B, Vallance A, French JJ, et al. Prognostic factors and survival after resection of colorectal liver metastasis in the era of preoperative chemotherapy: an 11-year single-centre study. Dig Surg. 2013;30(4–6):293–301.CrossRefPubMed

32.

Lake ES, Wadhwani S, Subar D, Kauser A, Harris C, Chang D, et al. The influence of FDG PET-CT on the detection of extrahepatic disease in patients being considered for resection of colorectal liver metastasis. Ann R Coll Surg Engl. 2014;96(3):211–5.PubMed

33.

Papathanassiou D, Bruna-Muraille C, Liehn JC, Nguyen TD, Cure H. Positron emission tomography in oncology: present and future of PET and PET/CT. Crit Rev Oncol Hematol. 2009;72(3):239–54.CrossRefPubMed

34.

Cohade C, Osman M, Leal J, Wahl RL. Direct comparison of (18)F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med. 2003;44(11):1797–803.PubMed

35.

Tann M, Sandrasegaran K, Jennings SG, Skandarajah A, McHenry L, Schmidt CM. Positron-emission tomography and computed tomography of cystic pancreatic masses. Clin Radiol. 2007;62(8):745–51.CrossRefPubMed

36.

Goerres GW, Kamel E, Seifert B, Burger C, Buck A, Hany TF, et al. Accuracy of image coregistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med. 2002;43(11):1469–75.PubMed

37.

Engledow AH, Skipworth JR, Pakzad F, Imber C, Ell PJ, Groves AM. The role of 18FDG PET/CT in the management of colorectal liver metastases. HPB (Oxford). 2012;14(1):20–5.CrossRef

38.

Wiering B, Krabbe PF, Dekker HM, Oyen WJ, Ruers TJ. The role of FDG-PET in the selection of patients with colorectal liver metastases. Ann Surg Oncol. 2007;14(2):771–9.CrossRefPubMed

39.

Chua SC, Groves AM, Kayani I, Menezes L, Gacinovic S, Du Y, et al. The impact of 18 F-FDG PET/CT in patients with liver metastases. Eur J Nucl Med Mol Imaging. 2007;34(12):1906–14.CrossRefPubMed

40.

Ruers TJ, Wiering B, van der Sijp JR, Roumen RM, de Jong KP, Comans EF, et al. Improved selection of patients for hepatic surgery of colorectal liver metastases with (18)F-FDG PET: a randomized study. J Nucl Med. 2009;50(7):1036–41.CrossRefPubMed

Title: Predictors of early recurrence after resection of colorectal liver metastases
Authors: Ricky Harminder Bhogal
James Hodson
Simon Roderick Bramhall
John Isaac
Ravi Marudanayagam
Darius Feroze Mirza
Paolo Muiesan
Robert Peter Sutcliffe
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-015-0549-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of early recurrence after resection of colorectal liver metastases

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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