Actual 10-year survival after resection of colorectal liver metastases defines cure Journal Article

Authors: Tomlinson, J. S.; Jarnagin, W. R.; DeMatteo, R. P.; Fong, Y.; Kornprat, P.; Gonen, M.; Kemeny, N.; Brennan, M. F.; Blumgart, L. H.; D'Angelica, M.
Article Title: Actual 10-year survival after resection of colorectal liver metastases defines cure
Abstract: Purpose: 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. Methods: 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. Results: 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. Conclusion: 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. © 2007 by American Society of Clinical Oncology.
Keywords: adult; cancer survival; controlled study; treatment outcome; aged; disease-free survival; middle aged; cancer surgery; retrospective studies; major clinical study; mortality; postoperative period; liver neoplasms; follow up; lymph node metastasis; colorectal cancer; risk factors; retrospective study; cancer mortality; time factors; colorectal neoplasms; survival time; liver metastasis; cancer size; data analysis; neoplasm metastasis; liver resection; kaplan meier method
Journal Title: Journal of Clinical Oncology
Volume: 25
Issue: 29
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2007-10-10
Start Page: 4575
End Page: 4580
Language: English
DOI: 10.1200/jco.2007.11.0833
PUBMED: 17925551
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 125" - "Export Date: 17 November 2011" - "CODEN: JCOND" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Murray F Brennan
    756 Brennan
  2. Leslie H Blumgart
    340 Blumgart
  3. Ronald P DeMatteo
    597 DeMatteo
  4. Mithat Gonen
    701 Gonen
  5. William R Jarnagin
    583 Jarnagin
  6. Yuman Fong
    741 Fong
  7. Nancy Kemeny
    346 Kemeny