Abstract
299 Background: The number of colorectal liver metastases (CLM) is accepted as a strong predictor of survival after surgery. However, recent advances in multidisciplinary approaches have dramatically changed surgical outcomes of CLM. Clinical implications of aggressive surgery for advanced CLM need to be reviewed in relation to the trend in treatment strategies. Methods: We reviewed 581 patients who underwent curative hepatectomy for CLM from 1999 to 2012. One hundred and eighty-nine patients underwent surgery for advanced CLM (n ≥ 4) and were classified according to year of surgery (first: 1999–2003 [n = 30]; second: 2004–2008 [n = 82]; and third: 2009–2012 [n= 77]). The frequency of perioperative chemotherapy for CLM, preoperative gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI), and contrast-enhanced intraoperative ultrasonography (CE-IOUS), and long-term outcomes were compared among the three periods. Results: The frequency of perioperative chemotherapy, EOB-MRI, and CE-IOUS increased with time (P <.001). The 3-/5-year overall survival in the third period (58.7/51.8%) was similar to that in the second period (59.8/43.9%, P =.828) and that of 72 patients who had 1–3 CLM in the first period (70.8/51.0%, P =.991). Advanced CLM was an independent factor in the first (P =.001, hazard ratio: 2.91) and second (P=.040, hazard ratio: 1.56) periods. However, multivariate analysis revealed that advanced CLM was not a predictive factor of overall survival in the third period. Conclusions: The prognostic impact of advanced CLM diminished owing to evolution in multidisciplinary treatment. Aggressive surgery for advanced CLM offers favorable prognosis similar to that of patients with few CLM in the early period.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.