Recurrence Following Hepatectomy for Metastatic Colorectal Cancer: Development of a Model that Predicts Patterns of Recurrence and Survival

Background While several prognostic models have been developed to predict survival of patients who undergo hepatectomy for metastatic colorectal cancer (mCRC), few data exist to predict survival after recurrence. We sought to develop a model that predicts survival for patients who have developed rec...

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Bibliographic Details
Published in:Annals of surgical oncology 2012, Vol.19 (1), p.139-144
Main Authors: Hill, Charles R. St, Chagpar, Ryaz B., Callender, Glenda G., Brown, Russell E., Gilbert, Juliana E., Martin, Robert C. G., McMasters, Kelly M., Scoggins, Charles R.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Colorectal Cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Female
Follow-Up Studies
Hepatectomy
Humans
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Middle Aged
Models, Statistical
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - surgery
Oncology
Prognosis
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
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Summary:Background While several prognostic models have been developed to predict survival of patients who undergo hepatectomy for metastatic colorectal cancer (mCRC), few data exist to predict survival after recurrence. We sought to develop a model that predicts survival for patients who have developed recurrence following hepatectomy for mCRC. Methods A retrospective analysis was performed on data from consecutive patients that underwent hepatectomy for mCRC. Clinicopathologic data, recurrence patterns, and outcomes were analyzed. Kaplan–Meier survival analysis and univariate and multivariate analyses were performed. An integer-based model was created to predict the patterns of recurrence and survival after recurrence. Results This analysis included 280 patients with a median follow-up of 50.1 months. Of these, 53% underwent major hepatectomy and 87% had negative margins. Recurrent disease developed in 63% of patients. After hepatectomy, factors associated with short disease-free interval (DFI) and overall survival (OS) included CEA > 200 ng/ml ( P  1 metastasis ( P  1 liver metastasis. A simple predictive scoring system was developed from the beta coefficients of this analysis that correlated with recurrence pattern ( P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-011-1921-y