Journal
JOURNAL OF GASTROINTESTINAL SURGERY
Volume 17, Issue 2, Pages 352-359Publisher
SPRINGER
DOI: 10.1007/s11605-012-2103-3
Keywords
Liver resection; Unresectable colorectal liver metastases; Downsized liver metastases; Actual survival; Cure
Categories
Funding
- Centro Universitario Cattolico
- Catholic University
- Italian Ministry for Instruction, University and Research
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Survival with long-term follow-up following liver resection for unresectable colorectal liver metastases (CRLM) downsized by chemotherapy has rarely been reported. The aim of this study was to determine the chance of cure following liver resection for initially unresectable CRLM. Between January 2000 and December 2009, 61 patients underwent hepatectomy for unresectable liver-only CRLM downsized after chemotherapy. Cure was defined as a recurrence-free interval of at least 5 years after primary hepatectomy. Resectability of CRLM was achieved after a mean number of 11 courses, and 42.6 % of patients underwent liver resection after a parts per thousand yen10 courses. Postoperative mortality was nil, and morbidity rate was 19.7 %. The 5- and 10-year actuarial overall survival rates were 42.6 and 16.0 %. Of 30 patients with a follow-up a parts per thousand yen5 years, 11 were alive, yielding a 5-year actual overall survival rate of 36.7 %, and 7 (23.3 %) were considered cured because they are alive without recurrence. On multivariate analysis, response to chemotherapy was the only independent predictor of both overall and disease-free survival. Cure can be achieved in about 23 % of patients resected for initially unresectable CRLM downsized by chemotherapy. Liver resection can be safely performed in selected patients even after multiple courses of chemotherapy.
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