Prognostic significance of early recurrence: A conditional survival analysis in patients with resected colorectal liver metastasis Journal Article
| Authors: | Tan, M. C. B.; Butte, J. M.; Gonen, M.; Kemeny, N.; Fong, Y.; Allen, P. J.; Kingham, T. P.; DeMatteo, R. P.; Jarnagin, W. R.; D'Angelica, M. I. |
| Article Title: | Prognostic significance of early recurrence: A conditional survival analysis in patients with resected colorectal liver metastasis |
| Abstract: | Background For patients undergoing liver resection for colorectal metastases, specific clinico-pathological variables have been shown to be prognostic at baseline. This study analyses how the prognostic capability of these variables changes in a conditional survival model. Methods Retrospective review of a prospectively maintained database of patients who underwent an R0 resection of colorectal liver metastases from 1994 to 2004 at a single institution. Results In total, 807 patients were identified, with an 87-month median follow-up for survivors. Five- and 10-year disease-specific survivals (DSS) were 68% and 55%, respectively. The probability of further survival increased as the survival time increased. For 3-year survivors (n = 504), DSS were no longer significantly different between patients with a low (0-2) or high (3-5) clinical risk score (CRS, P = 0.19). On multivariate analysis, independent predictors of DSS for 3-year survivors were recurrence within the first 3 years after a liver resection, a pre-operative carcinoembryonic antigen (CEA) >200 ng/ml and disease-free interval <12 months prior to the diagnosis of liver metastasis. However, for those patients who were recurrence free at 1 year, no clinico-pathological variables retained prognostic significance. Discussion After 3 years of DSS and 1 year of recurrence-free survival, baseline clinico-pathological variables have a limited ability to predict future survival. Early post-operative recurrence appears to be the most useful single clinical feature in estimating conditional DSS. © 2013 International Hepato-Pancreato-Biliary Association. |
| Journal Title: | HPB |
| Volume: | 15 |
| Issue: | 10 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2013-10-01 |
| Start Page: | 803 |
| End Page: | 813 |
| Language: | English |
| DOI: | 10.1111/hpb.12136 |
| PROVIDER: | scopus |
| PUBMED: | 23782400 |
| PMCID: | PMC3791120 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: HPBIF" - "Source: Scopus" |
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