Erschienen in:
01.03.2004 | Original Scientific Reports
Metastatic Tumor Doubling Time: Most Important Prehepatectomy Predictor of Survival and Nonrecurrence of Hepatic Colorectal Cancer Metastasis
verfasst von:
Kuniya Tanaka, M.D., Ph.D., Hiroshi Shimada, M.D., Ph.D., Masaru Miura, M.D., Yoshiro Fujii, M.D., Shigeki Yamaguchi, M.D., Ph.D., Itaru Endo, M.D., Hitoshi Sekido, M.D., Ph.D., Shinji Togo, M.D., Ph.D., Hideyuki Ike, M.D., Ph.D.
Erschienen in:
World Journal of Surgery
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Ausgabe 3/2004
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Abstract
We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection (n = 144) for colorectal cancer liver metastases were studied retrospectively to identify factors that influence overall survival and recurrence in the remnant liver. Overall 5-year survival and nonrecurrence rates were 49.8% and 50.8%, respectively. By multivariate analysis, large liver tumors (p = 0.038), p53 expression by the liver tumor (p = 0.011), and a short liver metastasis doubling time (≤ 45 days, p = 0.013) negatively affected survival; doubling times > 45 days (adjusted relative risk 0.06; p < 0.001) positively influenced disease-free survival. In patients with remnant liver recurrence, a short doubling time was associated with short disease-free intervals (7.3 ± 6.2 months), multiple metastases (63.6%), and fewer attempts at repeat hepatectomy (22.7%). The doubling time determines tumor size and reflects the patient’s immune and nutritional status. A short doubling time is the most reliable risk factor for multiple metastases, early recurrence, and poor prognosis. Further studies with a larger number of patients are needed to confirm this conclusion.