Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study

Abstract Aim This study was undertaken to evaluate the long‐term outcomes of staged liver resection for synchronous liver metastases (SLM) from colorectal cancer (CRC), and to elucidate the prognostic impact and predictors of early recurrence (ER), which was defined as recurrence within 6 mo. Method...

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Main Authors: Shunsuke Kasai, Ryo Ashida, Teiichi Sugiura, Katsuhisa Ohgi, Mihoko Yamada, Shimpei Otsuka, Hiroyasu Kagawa, Akio Shiomi, Yusuke Kinugasa, Katsuhiko Uesaka
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Annals of Gastroenterological Surgery
Subjects:
Online Access:https://doi.org/10.1002/ags3.12628
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author Shunsuke Kasai
Ryo Ashida
Teiichi Sugiura
Katsuhisa Ohgi
Mihoko Yamada
Shimpei Otsuka
Hiroyasu Kagawa
Akio Shiomi
Yusuke Kinugasa
Katsuhiko Uesaka
author_facet Shunsuke Kasai
Ryo Ashida
Teiichi Sugiura
Katsuhisa Ohgi
Mihoko Yamada
Shimpei Otsuka
Hiroyasu Kagawa
Akio Shiomi
Yusuke Kinugasa
Katsuhiko Uesaka
author_sort Shunsuke Kasai
collection DOAJ
description Abstract Aim This study was undertaken to evaluate the long‐term outcomes of staged liver resection for synchronous liver metastases (SLM) from colorectal cancer (CRC), and to elucidate the prognostic impact and predictors of early recurrence (ER), which was defined as recurrence within 6 mo. Methods Patients with SLM from CRC, except for initially unresectable SLM, from January 2013 to December 2020 were included. First, overall survival (OS) and relapse‐free survival (RFS) after staged liver resection were evaluated. Second, eligible patients were classified as follows: patients who were unresectable after resection of CRC (UR), patients with ER, and patients without ER (non‐ER), and their OS after resection of CRC were compared. In addition, risk factors for ER were identified. Results The 3‐y OS and RFS rates after resection of SLM were 78.8% and 30.8%, respectively. Next, the eligible patients were classified as follows: ER (N = 24), non‐ER (N = 56), and UR (N = 24). The non‐ER group had a significantly better OS than the ER (3‐y OS: 89.7% vs 48.0%, P = .001) and UR (3‐y OS: 89.7% vs 61.6%, P < .001) groups, while there was no significant difference between the ER and UR groups in OS (3‐y OS: 48.0% vs 61.6%, P = .638). Increasing carcinoembryonic antigen (CEA) before and after resection of CRC was identified as an independent risk factor for ER. Conclusion Staged liver resection for SLM from CRC was feasible and useful for oncological evaluation, as changes in CEA could predict ER, which was associated with a poor prognosis.
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spelling doaj.art-727ab18615e04cbc925d08c411d6a8242023-03-28T08:33:09ZengWileyAnnals of Gastroenterological Surgery2475-03282023-03-017231832510.1002/ags3.12628Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort studyShunsuke Kasai0Ryo Ashida1Teiichi Sugiura2Katsuhisa Ohgi3Mihoko Yamada4Shimpei Otsuka5Hiroyasu Kagawa6Akio Shiomi7Yusuke Kinugasa8Katsuhiko Uesaka9Division of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDepartment of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo JapanDivision of Hepato‐Biliary‐Pancreatic Surgery Shizuoka Cancer Center Shizuoka JapanAbstract Aim This study was undertaken to evaluate the long‐term outcomes of staged liver resection for synchronous liver metastases (SLM) from colorectal cancer (CRC), and to elucidate the prognostic impact and predictors of early recurrence (ER), which was defined as recurrence within 6 mo. Methods Patients with SLM from CRC, except for initially unresectable SLM, from January 2013 to December 2020 were included. First, overall survival (OS) and relapse‐free survival (RFS) after staged liver resection were evaluated. Second, eligible patients were classified as follows: patients who were unresectable after resection of CRC (UR), patients with ER, and patients without ER (non‐ER), and their OS after resection of CRC were compared. In addition, risk factors for ER were identified. Results The 3‐y OS and RFS rates after resection of SLM were 78.8% and 30.8%, respectively. Next, the eligible patients were classified as follows: ER (N = 24), non‐ER (N = 56), and UR (N = 24). The non‐ER group had a significantly better OS than the ER (3‐y OS: 89.7% vs 48.0%, P = .001) and UR (3‐y OS: 89.7% vs 61.6%, P < .001) groups, while there was no significant difference between the ER and UR groups in OS (3‐y OS: 48.0% vs 61.6%, P = .638). Increasing carcinoembryonic antigen (CEA) before and after resection of CRC was identified as an independent risk factor for ER. Conclusion Staged liver resection for SLM from CRC was feasible and useful for oncological evaluation, as changes in CEA could predict ER, which was associated with a poor prognosis.https://doi.org/10.1002/ags3.12628carcinoembryonic antigencolorectal cancerearly recurrenceliver metastasisstaged liver resection
spellingShingle Shunsuke Kasai
Ryo Ashida
Teiichi Sugiura
Katsuhisa Ohgi
Mihoko Yamada
Shimpei Otsuka
Hiroyasu Kagawa
Akio Shiomi
Yusuke Kinugasa
Katsuhiko Uesaka
Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
Annals of Gastroenterological Surgery
carcinoembryonic antigen
colorectal cancer
early recurrence
liver metastasis
staged liver resection
title Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
title_full Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
title_fullStr Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
title_full_unstemmed Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
title_short Long‐term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence: A single‐center retrospective cohort study
title_sort long term outcomes of staged liver resection for synchronous liver metastases from colorectal cancer and the clinical impact of early recurrence a single center retrospective cohort study
topic carcinoembryonic antigen
colorectal cancer
early recurrence
liver metastasis
staged liver resection
url https://doi.org/10.1002/ags3.12628
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