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SHR Neuro Cancer Cardio Lipid Metab Microb

Tomlinson, JS; Jarnagin, WR; DeMatteo, RP; Fong, Y; Kornprat, P; Gonen, M; Kemeny, N; Brennan, MF; Blumgart, LH; D'Angelica, M.
Actual 10-year survival after resection of colorectal liver metastases defines cure.
J Clin Oncol. 2007; 25(29):4575-4580 Doi: 10.1200/JCO.2007.11.0833 [OPEN ACCESS]
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Co-authors Med Uni Graz: Kornprat Peter
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Abstract:: Resection of colorectal liver metastases (CLM) in selected patients has evolved as the standard of care during the last 20 years. In the absence of prospective randomized clinical trials, a survival benefit has been deduced relative to historical controls based on actuarial data. There is now sufficient follow-up on a significant number of patients to address the curative intent of resecting CLM. Retrospective review of a prospectively maintained database was performed on patients who underwent resection of CLM from 1985 to 1994. Postoperative deaths were excluded. Disease-specific survival (DSS) was calculated from the time of hepatectomy using the Kaplan-Meier method. There were 612 consecutive patients identified with 10-year follow-up. Median DSS was 44 months. There were 102 actual 10-year survivors. Ninety-nine (97%) of the 102 were disease free at last follow-up. Only one patient experienced a disease-specific death after 10 years of survival. In contrast, 34% of the 5-year survivors suffered a cancer-related death. Previously identified poor prognostic factors found among the 102 actual 10-year survivors included 7% synchronous disease, 36% disease-free interval less than 12 months, 25% bilobar metastases, 50% node-positive primary, 39% more than one metastasis, and 35% tumor size more than 5 cm. Patients who survive 10 years appear to be cured of their disease, whereas approximately one third of actual 5-year survivors succumb to a cancer-related death. In well-selected patients, there is at least a one in six chance of cure after hepatectomy for CLM. The presence of poor prognostic factors does not preclude the possibility of long-term survival and cure.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Aged -; Colorectal Neoplasms - mortality Colorectal Neoplasms - pathology Colorectal Neoplasms - therapy; Disease-Free Survival -; Female -; Humans -; Liver Neoplasms - mortality Liver Neoplasms - therapy; Male -; Middle Aged -; Neoplasm Metastasis -; Prognosis -; Retrospective Studies -; Risk Factors -; Time Factors -; Treatment Outcome -