NDLI: What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up.

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What defines 'cure' after liver resection for colorectal metastases? Results after 10 years of follow-up.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Pulitanò, Carlo Castillo, Federico Aldrighetti, Luca Bodingbauer, Martin Parks, Rowan W. Ferla, Gianfranco Wigmore, Stephen J. Garden, O. James
Spatial Coverage	Scotland Italy
Description	Country affiliation: United kingdom Author Affiliation: Pulitanò C ( Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.)
Abstract	BACKGROUND: During the last two decades, resection of colorectal liver metastases (CLM) in selected patients has become the standard of care, with 5-year survival rates of 25-58%. Although a substantial number of actual 5-year survivors are reported after resection, 5-year survival rates may be inadequate to evaluate surgical outcomes because a significant number of patients experience a recurrence at some point. OBJECTIVES: This study aimed to analyse longterm results and prognostic factors in liver resection for CLM in patients with complete 10-year follow-up data. METHODS: A total of 369 patients who underwent liver resection for CLM between 1985 and 1998 were identified from a bi-institutional database. Postoperative deaths and patients with extrahepatic disease were excluded. Clinicopathological prognostic factors were analysed using univariate and multivariate analyses. RESULTS: The sample included 309 consecutive patients with complete 10-year follow-up data. Five- and 10-year overall survival rates were 32% and 23%, respectively. Overall, 93% of recurrences occurred within the first 5 years of follow-up, but 11% of patients who were disease-free at 5 years developed later recurrence. Multivariate analysis demonstrated four independent negative prognostic factors for survival: more than three metastases; a positive surgical margin; tumour size >5 cm, and a clinical risk score >2. CONCLUSIONS: Five-year survival rates are not adequate to evaluate surgical outcomes of patients with CLM. Approximately one-third of actual 5-year survivors suffer cancer-related death, whereas patients who survive 10 years appear to be cured of disease.
File Format	HTM / HTML
ISSN	1365182X
e-ISSN	14772574
DOI	10.1111/j.1477-2574.2010.00155.x
Journal	HPB
Issue Number	4
Volume Number	12
Language	English
Publisher	Elsevier
Publisher Date	2010-05-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Gastroenterology Colorectal Neoplasms Pathology Hepatectomy Liver Neoplasms Surgery Terminology As Topic Chemotherapy, Adjuvant Databases As Topic Disease-free Survival Adverse Effects Mortality Kaplan-meier Estimate Proportional Hazards Models Risk Assessment Risk Factors Scotland Time Factors Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology

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