Background
Materials and methods
Patients
LR for CRC hepatic metastases
Postoperative follow-up
Statistical analysis
Results
Demographics and clinicopathologic characteristics
Characteristics | Era 1 n= 128 (%) | Era 2 n= 151 (%) | p value |
---|---|---|---|
Age in years, median (range) | 59 (21-81) | 63 (29-88) | 0.009 |
Gender | 0.194 | ||
Male | 76 (59.4) | 101 (66.9) | |
Female | 52 (40.6) | 50 (33.1) | |
Primary tumor location | 0.112 | ||
Colon | 65 (50.8) | 91 (60.3) | |
Rectum | 63 (49.2) | 60 (39.7) | |
Liver metastasis | |||
CEA (mg/dL), median (range) | 15.5 (0.5-7025) | 12.4 (0.8-4280) | 0.743 |
Metastatic type | 0.471 | ||
Synchronous | 85 (66.4) | 94 (62.3) | |
Metachronous | 43 (33.6) | 57 (37.7) | |
Tumor number | < 0.0001 | ||
Solitary | 97 (75.8) | 84 (55.6) | |
Multiple | 31 (24.2) | 67 (44.4) | |
Maximum tumor size (cm) | 0.331 | ||
< 5 | 108 (85.7) | 122 (81.3) | |
≥5 | 20 (14.3) | 29 (18.7) | |
Extent of liver resection | 0.209 | ||
< 3 segments | 88 (68.8) | 114 (75.5) | |
≥ 3 segments | 40 (31.2) | 37 (24.5) | |
Perioperative chemotherapy | < 0.0001 | ||
FU or with LV | 69 (54.0) | 8 (5.3) | |
FU/LV/oxaliplatin | 9 (7.0) | 36 (23.8) | |
FU/LV/irinotecan | 9 (7.0) | 67 (44.4) | |
Other regimens | 22 (17.2) | 30 (19.9) | |
No | 19 (14.8) | 10 (6.6) | |
CRC recurrence | 0.008 | ||
IHR | 57 (44.5) | 43 (28.4) | |
SR | 48 (37.5) | 62 (41.1) | |
No | 23 (18.0) | 46 (30.5) | |
Resection of CRC recurrence | 10 (9.5)* | 31 (29.5)* | 0.003 |
Surgical mortality | 2 (1.6) | 2 (1.3) | 1.000 |
Prognostic factors affecting CRC recurrence
Factors | Era 1 | Era 2 | ||||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | |||||
n
| Medium RFS months (95%CI) | p value | p value |
n
| Medium RFS months (95%CI) | p value | p value | |
Age (years) | ||||||||
< 65 | 89 | 8.0 (6.9-9.0) | 0.296 | - | 84 | 12.0 (8.3-15.7) | 0.300 | - |
≥65 | 39 | 12.0 (9.7-14.3) | 67 | 21.0 (16.4-25.7) | ||||
Gender | ||||||||
Female | 52 | 10.0 (8.1-11.9) | 0.274 | - | 50 | 24.4 (11.7-37.1) | 0.014 | 0.218 |
Male | 76 | 9.0 (7.5-10.4) | 101 | 14.5 (10.1-18.9) | ||||
Primary tumor | ||||||||
Colon | 65 | 11.0 (8.9-13.0) | 0.116 | - | 91 | 17.5 (10.4-24.6) | 0.961 | - |
Rectum | 63 | 8.0 (6.1-9.9) | 60 | 16 (6.6-25.3) | ||||
Serum CEA (mg/dL) | ||||||||
≤200 | 83 | 11.0 (8.8-13.1) | 0.550 | - | 115 | 17.5 (11.0-24.0) | 0.362 | - |
> 200 | 38 | 9.0 (7.8-10.1) | 94 | 15.3 (6.5-24.0) | ||||
Metastatic type | ||||||||
Synchronous | 85 | 8.0 (6.8-9.2) | 0.052 | 0.075 | 94 | 12.9 (8.5-17.3) | 0.009 | 0.076 |
Metachronous | 43 | 11.0 (8.8-13.1) | 57 | 21.0 (7.4-34.7) | ||||
Tumor number | ||||||||
Solitary | 97 | 10.0 (8.8-11.1) | 0.022 | 0.035 | 84 | 22.1 (16.5-27.8) | 0.001 | 0.028 |
Multiple | 31 | 7.0 (5.3-8.7) | 1.6 (1.0-2.5) | 67 | 12.0 (10.6-13.5) | 1.6 (1.1-2.4) | ||
Maximum tumor size | ||||||||
< 5 cm | 108 | 10.0 (8.8-11.2) | 0.939 | - | 122 | 18.0 (12.6-23.5) | 0.162 | - |
≥5 cm | 20 | 8.0 (3.1-2.9) | 29 | 11.9 (6.9-16.8) | ||||
Liver resection extent | ||||||||
< 3 segments | 88 | 10.0 (8.5-11.4) | 0.743 | - | 114 | 17.5 (11.1-23.9) | 0.257 | - |
≥3 segments | 40 | 9.0 (7.6-10.4) | 37 | 13.0 (6.0-19.9) | ||||
Resection margin (cm) | ||||||||
< 0.5 | 60 | 9.0 (7.5-10.4) | 0.773 | - | 87 | 12.0 (10.3-13.7) | 0.001 | 0.011 |
≥0.5 | 68 | 10.0 (8.0-11.9) | 64 | 23.3 (16.9-29.6) | 1.7 (1.1-2.6) | |||
Histology grade | ||||||||
Low grade | 116 | 10.0 (8.8-11.2) | 0.101 | - | 145 | 16.5 (11.0-22.0) | 0.921 | - |
High grade | 12 | 5.0 (2.1-7.9) | 6 | 5.3 (0.0-30.4) |
Factors | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
n
| Medium RFS months (95% CI) | p value | p value (HR, 95% CI) | |
Age (years) | ||||
< 65 | 173 | 10.0 (8.4-11.6) | 0.103 | - |
≥65 | 106 | 16.9 (9.9-24.0) | ||
Gender | ||||
Male | 177 | 12.0 (7.7-16.3) | 0.021 | 0.134 |
Female | 102 | 11.0 (9.0-13.0) | ||
Primary tumor | ||||
Colon | 156 | 12.9 (8.5-17.2) | 0.234 | - |
Rectum | 123 | 10.0 (8.5-11.5) | ||
Serum CEA (mg/dL) | ||||
< 200 | 198 | 12.0 (10.6-13.4) | 0.567 | - |
≥200 | 72 | 10.0 (7.3-12.7) | ||
Metastatic type | ||||
Synchronous | 179 | 10.8 (9.3-12.3) | 0.002 | 0.014 |
Metachronous | 100 | 15.0 (9.1-20.9) | 1.5 (1.1-2.0) | |
Tumor number | ||||
Solitary | 181 | 14.0 (8.9-19.1) | 0.001 | 0.028 |
Multiple | 98 | 10.0 (7.8-8.7) | 1.4 (1.0-1.9) | |
Maximum tumor size | ||||
< 5 cm | 230 | 12.0 (10.0-14.0) | 0.420 | - |
≥5 cm | 49 | 10.0 (6.9-13.1) | ||
Extent of liver resection | ||||
< 3 segments | 202 | 12.0 (9.3-14.7) | 0.235 | - |
≥3 segments | 77 | 10.0 (7.9-12.1) | ||
Resection margin (cm) | ||||
< 0.5 | 147 | 10.0 (8.5-11.5) | 0.019 | 0.073 |
≥0.5 | 132 | 14.5 (9.1-19.9) | ||
Histologic grade | ||||
Low grade | 261 | 12.0 (9.3-14.7) | 0.184 | - |
high grade | 18 | 5.3 (1.8-8.8) |