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Japanese Journal of Clinical Oncology Advance Access originally published online on June 8, 2006
Japanese Journal of Clinical Oncology 2006 36(6):368-375; doi:10.1093/jjco/hyl027
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© 2006 Foundation for Promotion of Cancer Research

Short Time to Recurrence After Hepatic Resection Correlates with Poor Prognosis in Colorectal Hepatic Metastasis

Shinichiro Takahashi, Masaru Konishi, Toshio Nakagohri, Naoto Gotohda, Norio Saito and Taira Kinoshita

Department of Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

For reprints and all correspondence: Shinichiro Takahashi, M.D., Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. E-mail: shtakaha{at}east.ncc.go.jp

Received November 22, 2005; accepted February 26, 2006

Background: Early recurrence is a major problem after hepatic resection of colorectal hepatic metastasis (CHM). Our aim was to investigate the relationship between time to recurrence after CHM resection and overall survival.

Methods: A retrospective analysis was performed for 101 consecutive patients who underwent hepatic resection for CHM and have been followed more than 5 years.

Results: Among 101 patients, 82 (81%) had a recurrence. Overall survival of patients with recurrence within 6 months after CHM resection was significantly worse than that of patients with recurrence after more than 6 months (P < 0.01). Overall survival was poorer when time to recurrence was shorter. One of the reasons for poor prognosis of patients with recurrence within 6 months was that only a few patients could undergo a second resection for recurrence after CHM resection. Histological type, including poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor, bilobar metastases, microscopic positive surgical margin and carcinoembryonic antigen (CEA) above 15 ng/ml had predictive value for decreased recurrence-free survival after CHM resection.

Conclusion: Short time to recurrence after CHM resection correlates with a poor prognosis. Histological type of poorly differentiated signet ring cell or mucinous adenocarcinoma in the primary tumor might be a predictor for early recurrence after CHM resection.

Key Words: colorectal cancer • hepatic metastasis • resection • recurrence


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