Five-year survival post hepatectomy for colorectal liver metastases in a real-world Chinese cohort: Recurrence patterns and prediction for potential cure

Background: Patients with a 5 -year recurrence -free survival post liver resection for colorectal cancer liver metastases (CRLM) are considered to be potentially cured. However, there is a deficit of data on long -term follow -up and the recurrence status among these patients in the Chinese population. We analyzed real -world follow -up data of patients with CRLM who underwent hepatectomy, explored the recurrence patterns, and established a prediction model for a potential cure scenario.Methods: Patients who underwent radical hepatic resection for CRLM during 2000- 2016, with actual follow -up data for at least 5 years, were enrolled. The observed survival rate was calculated and compared among the groups with different recurrence patterns. The predictive factors for 5 -year non-recurrence were determined using logistic regression analysis; a recurrence -free survival model was developed to predict long -term survival. Results: A total of 433 patients were included, of whom 113 patients were found non-recurrence after 5 years follow -up, with a potential cure rate of 26.1%. Patients with late recurrence (> 5 months) and lung relapse showed significantly superior survival. Repeated localized treatment significantly improved the long -term survival of patients with intrahepatic or extrahepatic recurrences. Multivariate analysis showed that RAS wild -type CRC, preoperative CEA < 10 ng/ml, and liver metastases <= 3 were independent factors for a 5 -year disease -free recurrence. A cure model was developed based on the above factors, achieving good performance in predicting long -term survival. Conclusions: About one quarter patients with CRLM could achieve potential cure with non-recurrence at 5 -year after surgery. The recurrence -free cure model could well distinguish the long -term survival, which would aid clinicians in determining the treatment strategy.

Automated summary

This study analyzed long-term recurrence and cure rates of colorectal cancer liver metastases patients in the Chinese population who underwent liver resection. A prediction model was established and it was found that about one quarter of patients achieved potential cure with no recurrence after 5 years. Late recurrence and lung relapse were identified as significant factors for improved long-term survival.