TY - JOUR
T1 - High resection rates of colorectal liver metastases after standardized follow-up and multimodal management
T2 - an outcome study within the COLOFOL trial
AU - Scherman, Peter
AU - Hansdotter, Pernilla
AU - Holmberg, Erik
AU - Viborg Mortensen, Frank
AU - Petersen, Sune H
AU - Rizell, Magnus
AU - Naredi, Peter
AU - Syk, Ingvar
AU - COLOFOL Study Group
A2 - Jess, Per
A2 - Wille-Jørgensen, Peer Anders
N1 - Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - BACKGROUND: Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy.METHODS: In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS.RESULTS: Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46-0.85).CONCLUSION: A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.
AB - BACKGROUND: Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy.METHODS: In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS.RESULTS: Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46-0.85).CONCLUSION: A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.
KW - Colorectal Neoplasms/pathology
KW - Follow-Up Studies
KW - Hepatectomy/adverse effects
KW - Humans
KW - Liver Neoplasms/surgery
KW - Neoplasm Recurrence, Local
KW - Outcome Assessment, Health Care
KW - Retrospective Studies
UR - http://www.scopus.com/inward/record.url?scp=85150836501&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2023.03.003
DO - 10.1016/j.hpb.2023.03.003
M3 - Journal article
C2 - 36967324
SN - 1365-182X
VL - 25
SP - 766
EP - 774
JO - HPB : the official journal of the International Hepato Pancreato Biliary Association
JF - HPB : the official journal of the International Hepato Pancreato Biliary Association
IS - 7
ER -