Patterns of recurrence following liver resection for colorectal metastases: Effect of primary rectal tumor site

Lia Assumpcao, Michael A. Choti, Ana Luiza Gleisner, Richard D. Schulick, Michael Swartz, Joseph Herman, Susan L Gearhart, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Hypothesis: Patients with rectal adenocarcinoma are at increased risk of locoregional recurrence compared with patients with colon cancer. This may affect the pattern of recurrence and survival rates following hepatic resection of liver metastases from rectal adenocarcinoma. Design: Retrospective review of a prospectively collected cancer center database. Patient and Methods: From April 1, 1984, to December 31, 2005, 582 patients with liver metastases from a primary colorectal adenocarcinoma underwent hepatic resection. Clinical and pathological factors were analyzed using Cox regression analyses and log-rank tests. Results: Of 582 patients, 141 (24.2%) had liver metastases from a primary rectal tumor site. Treatment of the primary rectal tumor most frequently included chemoradiation therapy (59.6%) and low anterior resection (63.1%). Most rectal tumors were pathological stage T3/T4 (85.8%) and N1 (68.1%). Treatment directed at the hepatic metastases included resection only (81.5%), resection plus radiofrequency ablation (17.8%), or radiofrequency ablation only (0.7%). With a median follow-up time of 30.7 months, 80 of 141 patients (56.7%) developed recurrence; 23 patients (16.3%) developed recurrence in the pelvis. Of 23 patients with pelvic recurrence, 56.5% also developed recurrence in the liver. The 3- and 5-year survival rates for all patients were 62.4% and 36.4%, respectively. Of 80 patients who had a recurrence following hepatic metastectomy, 23 (28.8%) underwent another operation. Following repeat metastectomy, 3- and 5-year survival rates were 76.7% and 38.6%, respectively. Conclusions: Following resection of hepatic rectal metastases, pelvic recurrence is relatively common, and most patients with pelvic recurrence will also develop recurrence in the liver. Surgery for recurrent disease following hepatic resection of rectal metastases is warranted among well-selected patients.

Original languageEnglish (US)
Pages (from-to)743-749
Number of pages7
JournalArchives of Surgery
Volume143
Issue number8
DOIs
StatePublished - Aug 2008

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Rectal Neoplasms
Neoplasm Metastasis
Recurrence
Liver
Adenocarcinoma
Survival Rate
Pelvis
Colonic Neoplasms
Therapeutics
Regression Analysis
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Assumpcao, L., Choti, M. A., Gleisner, A. L., Schulick, R. D., Swartz, M., Herman, J., ... Pawlik, T. M. (2008). Patterns of recurrence following liver resection for colorectal metastases: Effect of primary rectal tumor site. Archives of Surgery, 143(8), 743-749. https://doi.org/10.1001/archsurg.143.8.743

Patterns of recurrence following liver resection for colorectal metastases : Effect of primary rectal tumor site. / Assumpcao, Lia; Choti, Michael A.; Gleisner, Ana Luiza; Schulick, Richard D.; Swartz, Michael; Herman, Joseph; Gearhart, Susan L; Pawlik, Timothy M.

In: Archives of Surgery, Vol. 143, No. 8, 08.2008, p. 743-749.

Research output: Contribution to journalArticle

Assumpcao, L, Choti, MA, Gleisner, AL, Schulick, RD, Swartz, M, Herman, J, Gearhart, SL & Pawlik, TM 2008, 'Patterns of recurrence following liver resection for colorectal metastases: Effect of primary rectal tumor site', Archives of Surgery, vol. 143, no. 8, pp. 743-749. https://doi.org/10.1001/archsurg.143.8.743
Assumpcao, Lia ; Choti, Michael A. ; Gleisner, Ana Luiza ; Schulick, Richard D. ; Swartz, Michael ; Herman, Joseph ; Gearhart, Susan L ; Pawlik, Timothy M. / Patterns of recurrence following liver resection for colorectal metastases : Effect of primary rectal tumor site. In: Archives of Surgery. 2008 ; Vol. 143, No. 8. pp. 743-749.
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title = "Patterns of recurrence following liver resection for colorectal metastases: Effect of primary rectal tumor site",
abstract = "Hypothesis: Patients with rectal adenocarcinoma are at increased risk of locoregional recurrence compared with patients with colon cancer. This may affect the pattern of recurrence and survival rates following hepatic resection of liver metastases from rectal adenocarcinoma. Design: Retrospective review of a prospectively collected cancer center database. Patient and Methods: From April 1, 1984, to December 31, 2005, 582 patients with liver metastases from a primary colorectal adenocarcinoma underwent hepatic resection. Clinical and pathological factors were analyzed using Cox regression analyses and log-rank tests. Results: Of 582 patients, 141 (24.2{\%}) had liver metastases from a primary rectal tumor site. Treatment of the primary rectal tumor most frequently included chemoradiation therapy (59.6{\%}) and low anterior resection (63.1{\%}). Most rectal tumors were pathological stage T3/T4 (85.8{\%}) and N1 (68.1{\%}). Treatment directed at the hepatic metastases included resection only (81.5{\%}), resection plus radiofrequency ablation (17.8{\%}), or radiofrequency ablation only (0.7{\%}). With a median follow-up time of 30.7 months, 80 of 141 patients (56.7{\%}) developed recurrence; 23 patients (16.3{\%}) developed recurrence in the pelvis. Of 23 patients with pelvic recurrence, 56.5{\%} also developed recurrence in the liver. The 3- and 5-year survival rates for all patients were 62.4{\%} and 36.4{\%}, respectively. Of 80 patients who had a recurrence following hepatic metastectomy, 23 (28.8{\%}) underwent another operation. Following repeat metastectomy, 3- and 5-year survival rates were 76.7{\%} and 38.6{\%}, respectively. Conclusions: Following resection of hepatic rectal metastases, pelvic recurrence is relatively common, and most patients with pelvic recurrence will also develop recurrence in the liver. Surgery for recurrent disease following hepatic resection of rectal metastases is warranted among well-selected patients.",
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AU - Assumpcao, Lia

AU - Choti, Michael A.

AU - Gleisner, Ana Luiza

AU - Schulick, Richard D.

AU - Swartz, Michael

AU - Herman, Joseph

AU - Gearhart, Susan L

AU - Pawlik, Timothy M.

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N2 - Hypothesis: Patients with rectal adenocarcinoma are at increased risk of locoregional recurrence compared with patients with colon cancer. This may affect the pattern of recurrence and survival rates following hepatic resection of liver metastases from rectal adenocarcinoma. Design: Retrospective review of a prospectively collected cancer center database. Patient and Methods: From April 1, 1984, to December 31, 2005, 582 patients with liver metastases from a primary colorectal adenocarcinoma underwent hepatic resection. Clinical and pathological factors were analyzed using Cox regression analyses and log-rank tests. Results: Of 582 patients, 141 (24.2%) had liver metastases from a primary rectal tumor site. Treatment of the primary rectal tumor most frequently included chemoradiation therapy (59.6%) and low anterior resection (63.1%). Most rectal tumors were pathological stage T3/T4 (85.8%) and N1 (68.1%). Treatment directed at the hepatic metastases included resection only (81.5%), resection plus radiofrequency ablation (17.8%), or radiofrequency ablation only (0.7%). With a median follow-up time of 30.7 months, 80 of 141 patients (56.7%) developed recurrence; 23 patients (16.3%) developed recurrence in the pelvis. Of 23 patients with pelvic recurrence, 56.5% also developed recurrence in the liver. The 3- and 5-year survival rates for all patients were 62.4% and 36.4%, respectively. Of 80 patients who had a recurrence following hepatic metastectomy, 23 (28.8%) underwent another operation. Following repeat metastectomy, 3- and 5-year survival rates were 76.7% and 38.6%, respectively. Conclusions: Following resection of hepatic rectal metastases, pelvic recurrence is relatively common, and most patients with pelvic recurrence will also develop recurrence in the liver. Surgery for recurrent disease following hepatic resection of rectal metastases is warranted among well-selected patients.

AB - Hypothesis: Patients with rectal adenocarcinoma are at increased risk of locoregional recurrence compared with patients with colon cancer. This may affect the pattern of recurrence and survival rates following hepatic resection of liver metastases from rectal adenocarcinoma. Design: Retrospective review of a prospectively collected cancer center database. Patient and Methods: From April 1, 1984, to December 31, 2005, 582 patients with liver metastases from a primary colorectal adenocarcinoma underwent hepatic resection. Clinical and pathological factors were analyzed using Cox regression analyses and log-rank tests. Results: Of 582 patients, 141 (24.2%) had liver metastases from a primary rectal tumor site. Treatment of the primary rectal tumor most frequently included chemoradiation therapy (59.6%) and low anterior resection (63.1%). Most rectal tumors were pathological stage T3/T4 (85.8%) and N1 (68.1%). Treatment directed at the hepatic metastases included resection only (81.5%), resection plus radiofrequency ablation (17.8%), or radiofrequency ablation only (0.7%). With a median follow-up time of 30.7 months, 80 of 141 patients (56.7%) developed recurrence; 23 patients (16.3%) developed recurrence in the pelvis. Of 23 patients with pelvic recurrence, 56.5% also developed recurrence in the liver. The 3- and 5-year survival rates for all patients were 62.4% and 36.4%, respectively. Of 80 patients who had a recurrence following hepatic metastectomy, 23 (28.8%) underwent another operation. Following repeat metastectomy, 3- and 5-year survival rates were 76.7% and 38.6%, respectively. Conclusions: Following resection of hepatic rectal metastases, pelvic recurrence is relatively common, and most patients with pelvic recurrence will also develop recurrence in the liver. Surgery for recurrent disease following hepatic resection of rectal metastases is warranted among well-selected patients.

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