AI Article Synopsis
- Improved surgical techniques and therapy have enabled more patients with oligometastatic colorectal cancer to qualify for surgery, but many still experience recurrence, which varies by site and outcome.
- A study of 195 patients who had liver metastasis resection revealed that the one-year recurrence-free survival was 46%, while overall survival rates were high at 95% for the same period; several prognostic factors for worse outcomes were identified.
- The findings highlight the need for further research to pinpoint patients at increased risk of recurrence, potentially guiding additional preventive treatment strategies.
Article Abstract
Background: Improved surgical techniques and more intensive systemic therapy have increased the number of patients with oligometastatic colorectal cancer eligible for resection, but a significant percentage of these cases will ultimately recur. Furthermore, distinct recurrence patterns have been associated with different outcomes.
Methods: Data for 195 patients who underwent curative-intent colorectal liver metastasis (CRLM) resection between 2016 and 2022 at Johns Hopkins Hospital were retrospectively collected. Cox regression univariate and multivariate analyses identified features associated with survival outcomes. Association between risk factors and site of recurrences was conducted via logistic regression with initial recurrences grouped into intrahepatic-only, extrahepatic-only, and concurrent intra- and extrahepatic recurrence.
Results: The 1- and 2-year recurrence-free survival (RFS) rates were 46% and 22%, respectively. The 1- and 2-year overall survival (OS) rates were 95% and 88%, respectively. The median OS was 71.7 months. Multivariate analysis identified age <60 years, N2 nodal status, R1 liver margin, and higher preoperative carcinoembryonic antigen as top prognostic factors for worse RFS. Additionally, patients with left-sided primary tumors had a higher risk of intrahepatic-only recurrence, whereas mutant KRAS was associated with a higher risk of extrahepatic recurrence with or without liver recurrence.
Conclusion: These results from a recent cohort of patients treated with current standard-of-care therapies identify features associated with elevated risk and specific patterns of recurrence. These insights into CRLM recurrence patterns support a larger prospective study to identify subgroups of patients who may require additional therapies to prevent recurrence.
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| http://dx.doi.org/10.1016/j.gassur.2024.09.026 | DOI Listing |
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