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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2019

01-01-2019 | Hepatobiliary Tumors

Intrahepatic Recurrence Patterns Predict Survival After Resection of Colorectal Liver Metastases

Authors: Andrew J. Lee, MD, PhD, Evelyne M. Loyer, MD, Hyunseon C. Kang, MD, Thomas A. Aloia, MD, Ching-Wei D. Tzeng, MD, Jean-Nicolas Vauthey, MD, Yun Shin Chun, MD

Published in: Annals of Surgical Oncology | Issue 1/2019

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Abstract

Background

After resection of colorectal liver metastases (CLM), up to 40% of patients will develop intrahepatic recurrence. This study aims to identify patterns of intrahepatic recurrence and their impact on survival after preoperative chemotherapy and CLM resection.

Methods

A retrospective review was performed of patients developing intrahepatic recurrence after CLM resection following preoperative chemotherapy. Prechemotherapy, preoperative, and postoperative computed tomography scans were reviewed. Recurrences were classified as in situ, de novo, or both in situ and de novo. Median follow-up was 42 months (range 2–144 months).

Results

Among 223 patients meeting study criteria, intrahepatic recurrence was identified a median of 9 months after hepatectomy. Isolated de novo or in situ recurrence developed in 105 (47%) and 86 (39%) patients, respectively. Thirty-two patients (14%) developed both in situ and de novo recurrence, which was associated with significantly lower median overall survival of 33 months compared with 49 and 45 months with isolated in situ or de novo recurrence, respectively (p = 0.048). Among 118 patients (53%) who developed in situ recurrence as a component of disease relapse, recurrences resulted from disappearing or missed liver metastases in 47 patients (40%).

Conclusions

An intrahepatic recurrence pattern of both in situ and de novo metastases after CLM resection following preoperative chemotherapy predicts significantly worse overall survival compared with isolated in situ or de novo recurrence.
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Metadata
Title
Intrahepatic Recurrence Patterns Predict Survival After Resection of Colorectal Liver Metastases
Authors
Andrew J. Lee, MD, PhD
Evelyne M. Loyer, MD
Hyunseon C. Kang, MD
Thomas A. Aloia, MD
Ching-Wei D. Tzeng, MD
Jean-Nicolas Vauthey, MD
Yun Shin Chun, MD
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6945-0

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