Faculty Collaboration Database

Interaction of tumour biology and tumour burden in determining outcome after hepatic resection for colorectal metastases. HPB (Oxford) 2010 Mar;12(2):84-93

Date

05/25/2010

Pubmed ID

20495651

Pubmed Central ID

PMC2826665

DOI

10.1111/j.1477-2574.2009.00127.x

Scopus ID

2-s2.0-77449154624 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

AIMS: To determine the outcome of colorectal liver metastasis (CRLM) patients based on tumour burden, represented by tumour number and size, and tumour biology as assessed by an inflammatory response to tumour (IRT) and margin positivity.

METHODS: Data were collated from CRLM patients undergoing resection from January 1993 to March 2007. Patients were divided into: low (<or=3 metastases and/or <or=3 cm); moderate (4-7 metastases and/or >3-<or=5 cm); and high (>or=8 metastases and/or >5 cm) tumour burden.

RESULTS: Seven hundred and five patients underwent resection, of which 154 (21.8%), 262 (37.2%) and 289 (41.0%) patients were in the low, moderate and high tumour burden groups, respectively. The 5-year disease-free (P < 0.001) and overall (P < 0.001) survival were significantly different between the groups. IRT (P < 0.001), extent of resection (P < 0.001) and margin (P < 0.001) also differed between the groups. Sub-group analysis revealed that IRT was the only adverse predictor for disease-free and overall survival in the low group. In the moderate group, IRT predicted poorer disease-free survival on multi-variate analysis. In the high group, R1 resection and transfusion were predictors of poorer disease-free survival and age >or=65 years, R1 resection and IRT were adverse predictors of overall survival.

CONCLUSION: Resection margin influenced the outcome of patients with high tumour burden, hence the importance of achieving clear margins. IRT influenced the outcome of patients with less aggressive disease.

Author List

Gomez D, Morris-Stiff G, Toogood GJ, Lodge JP, Prasad KR

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Blood Transfusion
Chi-Square Distribution
Colorectal Neoplasms
Disease-Free Survival
England
Female
Hepatectomy
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Male
Middle Aged
Neoplasm Recurrence, Local
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
Transfusion Reaction
Treatment Outcome
Tumor Burden