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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 4/2021

01-06-2021 | Metastasis | Original Article

Efficacy of the Milan criteria as a prognostic factor in patients with colorectal liver metastases

Authors: Naokazu Chiba, Yuta Abe, Itsuki Koganezawa, Masashi Nakagawa, Kei Yokozuka, Yosuke Ozawa, Toshimichi Kobayashi, Toru Sano, Koichi Tomita, Rina Tsutsui, Shigeyuki Kawachi

Published in: Langenbeck's Archives of Surgery | Issue 4/2021

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Abstract

Purpose

This study aimed to apply the principles of the “Milan criteria” to patients undergoing hepatic resection for CRLM and to evaluate the efficacy of prognostic factors.

Methods

The medical records of consecutive patients who underwent curative resection for CRLM from April 2007 to April 2019 were retrospectively reviewed. Time to aggressive treatment failure (TATF) was defined as the time interval from the initial surgery until the first unresectable recurrence or recurrence that could only be treated with doublet or lower dose chemotherapy, or death. The risk factors associated with recurrence-free survival (RFS), TSF, TATF, and overall survival (OS) were evaluated.

Results

On univariate analysis, the Milan criteria significantly predicted long-term OS, TATF, TSF, and RFS. Moreover, the Milan criteria were able to stratify patients with CRLM into distinct prognostic groups with regard to long-term OS, TATF, TSF, and RFS.

Conclusions

Milan criteria, a simple index, are a factor contributing to all the survival time and are a very important factor in discussing the prognosis of CRLM.
Appendix
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Literature
1.
Kopetz S, Chang GJ, Overman MJ, Eng C, Sargent DJ, Larson DW, Grothey A, Vauthey JN, Nagorney DM, McWilliams RR (2009) Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol 27:3677–3683CrossRef
2.
House MG, Ito H, Gonen M et al (2010) Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surg 210:744–752CrossRef
3.
de Jong MC, Pulitano C, Ribero D, Strub J, Mentha G, Schulick RD, Choti MA, Aldrighetti L, Capussotti L, Pawlik TM (2009) Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg 250:440–448CrossRef
4.
Saiura A, Yamamoto J, Hasegawa K, Koga R, Sakamoto Y, Hata S, Makuuchi M, Kokudo N (2012) Liver resection for multiple colorectal liver metastases with surgery up-front approach: bi-institutional analysis of 736 consecutive cases. World J Surg 36:2171–2178CrossRef
5.
Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D et al (2004) Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 240:644–657CrossRef
6.
Figueras J, Valls C, Rafecas A, Fabregat J, Ramos E, Jaurrieta E (2001) Resection rate and effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br J Surg 88:980–985CrossRef
7.
Zakaria S, Donohue JH, Que FG, Farnell MB, Schleck CD, Ilstrup DM, Nagorney DM (2007) Hepatic resection for colorectal metastases: value for risk scoring systems? Ann Surg 246:183–191CrossRef
8.
Beppu T, Sakamoto Y, Hasegawa K, Hond G, Tanaka K et al (2012) A nomogram predicting disease-free survival in patients with colorectal liver metastases treated with hepatic resection: multicenter data collection as a Project Study for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. JHPBS. 19:72–84
9.
Sakaki K, Morioka D, Conci S, Margonis GA, Sawada Y, Ruzzenente A et al (2018) The tumor burden score A new “Metro-ticket” prognostic tool for colorectal liver metastases based on tumor size and number of tumors. Ann Surg 267:132–141CrossRef
10.
Gomez D, Cameron IC (2010) Prognostic scores for colorectal liver metastasis: clinically important or an academic exercise? HPB (Oxford) 12:227–238CrossRef
11.
Kanas GP, Taylor A, Primrose JN, Langeberg WJ, Kelsh MA, Mowat FS, Alexander DD, Choti MA, Poston G (2012) Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors. Clin Epidemiol 4:283–301PubMedPubMedCentral
12.
Decaens T, Roudot-Thoraval F, Hadni-Bresson S, Meyer C, Gugenheim J, Durand F, Bernard PH, Boillot O, Sulpice L, Calmus Y, Hardwigsen J, Ducerf C, Pageaux GP, Dharancy S, Chazouilleres O, Cherqui D, Duvoux C (2006) Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time. Liver Transpl 12:1761–1769CrossRef
13.
Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334:693–699CrossRef
14.
Oba M, Hasegawa K, Matsuyama Y, Shindoh J, Mise Y, Aoki T, Sakamoto Y, Sugawara Y, Makuuchi M, Kokudo N (2014) Discrepancy between recurrence-free survival and overall survival in patients with resectable colorectal liver metastases: a potential surrogate endpoint for time to surgical failure. Ann Surg Oncol 21(6):1817–1824CrossRef
15.
Margonis GA, Buettner S, Andreatos N, Wagner D, Sasaki K, Barbon C, Beer A, Kamphues C, Løes IM, He J, Pawlik TM, Kaczirek K, Poultsides G, Lønning PE, Cameron JL, Mischinger HJ, Aucejo FN, Kreis ME, Wolfgang CL, Weiss MJ (2019) Prognostic factors change over time after hepatectomy for colorectal liver metastases: a multi-institutional, international analysis of 1099 patients. Ann Surg 269(6):1129–1137CrossRef
Metadata
Title
Efficacy of the Milan criteria as a prognostic factor in patients with colorectal liver metastases
Authors
Naokazu Chiba
Yuta Abe
Itsuki Koganezawa
Masashi Nakagawa
Kei Yokozuka
Yosuke Ozawa
Toshimichi Kobayashi
Toru Sano
Koichi Tomita
Rina Tsutsui
Shigeyuki Kawachi
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 4/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-021-02088-x

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