Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2006-2-3
pubmed:abstractText
Treatment of four or more colorectal liver metastases (CRLMs) is controversial and remains a relative contraindication to surgery at some institutions. We sought to assess the outcome of patients with four or more CRLMs treated with surgery. Patients (159) with four or more CRLMs were treated surgically at a single institution. The median number of treated lesions was 5 (range, 4-14). The majority of patients received neoadjuvant chemotherapy (89.9%). Forty-six (29.0%) patients underwent resection only, 12 (7.5%) underwent radiofrequency ablation (RFA) only, and 101 (63.5%) underwent resection plus RFA. The 5-year actuarial disease-free and overall survival rates were 21.5% and 50.9%, respectively. Patients who underwent RFA as part of their surgical procedure (hazard ratio [HR] = 1.81, P = 0.03) and those with a positive surgical resection margin (HR = 1.52, P = 0.01) were more likely to have a shorter time to recurrence. Patients who did not have a reduction in tumor size following neoadjuvant chemotherapy had a higher likelihood of death following surgical treatment (HR = 2.53, P = 0.01). Patients with four or more CRLMs should be considered for aggressive surgical treatment, including liver resection with or without RFA, in order to improve the chance of long-term survival. Certain clinicopathologic factors, including lack of response to neoadjuvant chemotherapy, were associated with a worse prognosis.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
1091-255X
pubmed:author
pubmed:issnType
Print
pubmed:volume
10
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
240-8
pubmed:meshHeading
pubmed-meshheading:16455457-Adult, pubmed-meshheading:16455457-Aged, pubmed-meshheading:16455457-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:16455457-Catheter Ablation, pubmed-meshheading:16455457-Chemotherapy, Adjuvant, pubmed-meshheading:16455457-Colorectal Neoplasms, pubmed-meshheading:16455457-Disease-Free Survival, pubmed-meshheading:16455457-Female, pubmed-meshheading:16455457-Follow-Up Studies, pubmed-meshheading:16455457-Hepatectomy, pubmed-meshheading:16455457-Humans, pubmed-meshheading:16455457-Liver Neoplasms, pubmed-meshheading:16455457-Male, pubmed-meshheading:16455457-Middle Aged, pubmed-meshheading:16455457-Neoplasm Recurrence, Local, pubmed-meshheading:16455457-Prognosis, pubmed-meshheading:16455457-Survival Rate, pubmed-meshheading:16455457-Treatment Outcome, pubmed-meshheading:16455457-Ultrasonography, Interventional
pubmed:year
2006
pubmed:articleTitle
Debunking dogma: surgery for four or more colorectal liver metastases is justified.
pubmed:affiliation
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
pubmed:publicationType
Journal Article