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2015 | 87 | 2 | 53-58
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Comparison of Total Tumor Volume, Size and Number of Colorectal Liver Metastases in Prediction of Survival in Patients after Liver Resection

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Liver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease. The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy. Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve. Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively.Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatment
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1 - 2 - 2015
1 - 8 - 2015
3 - 7 - 2015
  • 1. Wojciechowska U, Didkowska J: Zachorowania i zgony na nowotwory złośliwe w Polsce. Krajowy Rejestr Nowotworów, Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie. Dostępne na stronieępzdnia 01/12/2014
  • 2. Fong Y, Fortner J, Sun RL et al.: Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 1999; 230: 309-18
  • 3. Manfredi S, Lepage C, Hatem C et al.: Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 2006; 244: 254-59.
  • 4. Scheele J, Stang R, Altendorf-Hofmann A et al.: Resection of colorectal liver metastases. World J Surg 1995; 19(1): 59-71.
  • 5. Abdalla EK , Vauthey J-N, Ellis LM et al.: Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ ablation for colorectal liver metastases. Ann Surg 2004; 239: 818-27.
  • 6. Adam R, Delvart V, Pascal G et al:. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 2004; 240: 644-57.
  • 7. Bennett JJ, Cao D, Posner MC: Determinants of unresectability and outcome of patients with occult colorectal hepatic metastases. J Surg Oncol 2005; 92: 64-69.
  • 8. Hołówko W, Grąt M, Hinderer B et al.: Prediction of survival in patients with unresectable liver metastases from colorectal carcinoma. Pol Przegl Chir 2014; 86(7): 319-24.
  • 9. Steele G Jr, Ravikumar TS: Resection of hepatic metastases from colorectal cancer. Biologic perspective. Ann Surg 1989; 210(2): 127-38.
  • 10. Charnsangavej C, Clary B, Fong Y et al.: Selection of patients for resection of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol 2006; 13: 1261-68.
  • 11. Ribeiro HSC, Stevanato-Filho PR , Costa Jr. WL et al.: Prognostic factors for survival in patients with colorectal liver metastases: experience of a single Brazilian cancer center. Arq Gastroenterol 2012; 49(4): 266-72.
  • 12. Dexiang Z, Li R, Ye W et al.: Outcome of patients with colorectal liver metastasis: analysis of 1,613 consecutive cases. Ann Surg Oncol 2012; 19: 2860-68.
  • 13. Rees M, Tekkis PP , Welsh FK et al.: Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: multifocal model of 929 patients. Ann Surg 2008; 247(1): 125-35.
  • 14. Katoh H, Yamashita K, Kokuba Y et al. Surgical resection of stage IV colorectal cancer and prognosis. World J Surg 2008; 32(6): 1130-37.
  • 15. Yamaguchi T, Mori T, Takahashi K et al. A new classification system for liver metastases from colorectal cancer in Japanese multicenter analysis. Hepatogastroenterology 2008; 55(81): 173-78.
  • 16. Aldrighetti L, Castoldi R, Di Palo S et al.: Prognostic factors for long-term outcome of hepatic resection for colorectal liver metastases. Chir Ital 2005; 57(5): 555-70.
  • 17. Mann CD , Metcalfe MS, Leopardi LN et al.: The clinical risk score: emerging as a reliable preoperative prognostic index in hepatectomy for colorectal metastases. Arch Surg 2004; 139(11): 1168-72.
  • 18. Ercolani G, Grazi GL, Ravaioli M et al.: Liver resection for multiple colorectal metastases: influence of parenchymal involvement and total tumor volume, vs number or location, on long-term survival. Arch Surg 2002; 137(10): 1187-92.
  • 19. Gayowski TJ, Iwatsuki S, Madariaga JR et al.: Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathologic risk factors. Surgery 1994; 116(4): 703-10.
  • 20. Bouviez N, Lakkis Z, Lubrano J et al.: Liver resection for colorectal metastases: results and prognostic factors with 10-year follow-up. Arch Surg 2014; 399: 1031-38.
  • 21. John SK, Robinson SM, Rehman S et al.: Prognostic factors and survival after resection of colorectal liver metastases in the era of preoperative chemotherapy: an 11-year single-centre study. Dig Surg 2013; 30: 293-301.
  • 22. Zhou L, Zhag G, Tang T et al.: Retrospective analysis of clinical and pathologic risk factors in liver resection for hepatic colorectal metastases. J Can Res Ther 2013; 9: 176-80.
  • 23. Vigano L, Capussotti L, Majno P et al.: Liver resection in patients with eight or more colorectal liver metastases. BJS 2015; 102: 92-101.
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