Posttreatment Surveillance in Patients with Prolonged Disease-Free Survival After Resection of Colorectal Liver Metastasis

Introduction Posttreatment surveillance protocols most often endure for 5 years after resection of colorectal liver metastasis (CRLM). Most recurrences happen within 3 years after surgical removal of the tumour. This study analysed the need of surveillance for patients with at least 3 years of disea...

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Bibliographic Details
Published in:Annals of surgical oncology 2016-11, Vol.23 (12), p.3999-4007
Main Authors: Galjart, Boris, van der Stok, Eric P., Rothbarth, Joost, Grünhagen, Dirk J., Verhoef, Cornelis
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Disease-Free Survival
Female
Hepatectomy
Hepatobiliary Tumors
Humans
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - mortality
Oncology
Population Surveillance
Retrospective Studies
Risk Factors
Surgery
Surgical Oncology
Time Factors
Watchful Waiting
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Summary:Introduction Posttreatment surveillance protocols most often endure for 5 years after resection of colorectal liver metastasis (CRLM). Most recurrences happen within 3 years after surgical removal of the tumour. This study analysed the need of surveillance for patients with at least 3 years of disease-free survival after potentially curative resection of CRLM. Methods A single-centre, retrospective analysis of all consecutive patients who underwent treatment for CRLM with curative intent between 2000 and 2011. Results In total, 152 of 545 patients (28 %) remained disease-free for 3 years after successful resection of the CRLM. The estimated recurrence rate after 10 years of follow-up in this group of 152 patients was 27 %. More than half of these patients (55 %) could be treated with curative intent for their recurrences. Multivariable analysis revealed that the nodal status of the primary tumour is of significant prognostic value for developing recurrences after 3 years of disease-free survival. A disease-free interval of less than 12 months between resection of primary tumour and detection of CRLM shows a trend towards significance. Both factors were used to create a risk score, showing that patients with a low-risk profile (node-negative status and a disease-free interval 
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-016-5388-8