TY - JOUR
T1 - Conditional Survival After Hepatectomy for Colorectal Liver Metastasis
T2 - Results from the Colorectal Liver Operative Metastasis International Collaborative (COLOMIC)
AU - Valenzuela, Cristian D.
AU - Moaven, Omeed
AU - Solsky, Ian B.
AU - Stauffer, John A.
AU - Del Piccolo, Nico R.
AU - Cheung, Tanto
AU - Corvera, Carlos U.
AU - Wisneski, Andrew D.
AU - Cha, Charles H.
AU - Pourhabibi Zarandi, Nima
AU - Dourado, Justin
AU - Perry, Kathleen C.
AU - Russell, Gregory
AU - Shen, Perry
N1 - Publisher Copyright:
© 2023, Society of Surgical Oncology.
PY - 2023/6
Y1 - 2023/6
N2 - Introduction: Complete resection of colorectal liver metastasis (CLM) improves long-term survival in colorectal cancer. However, there is limited recent data on conditional survival (CS) as postoperative survival milestones are achieved post-hepatectomy. Methods: A retrospective analysis was performed on the penta-institutional Colorectal Liver Operative Metastasis International Collaborative (COLOMIC), with 906 consecutive CLM hepatectomy cases. CS was calculated using Bayes’ theorem and Kaplan-Meier analysis. Additional CS analyses were performed on additional clinicopathologic risk factors, including colon cancer laterality, KRAS mutation status, and extrahepatic disease. Results: The 5-year CS was 40.6%, 45.3%, 52.8%, and 65.3% at 0, 1, 2, and 3 years postoperatively, with significant improvements each year (p < 0.005). CS was not significantly different between right-sided and left-sided colorectal cancers by 3 years postoperatively. Patients with KRAS mutations had worse CS at all timepoints (p < 0.001). Extrahepatic disease was a poor prognostic factor for OS and CS (p < 0.001). However, CS for patients with KRAS mutations or extrahepatic disease improved significantly as 2-year, postoperative survival was achieved (p < 0.05). Conclusions: Five-year CS after hepatectomy for CLM improved with each passing year of survival postoperatively. Although extrahepatic disease and KRAS mutations are poor prognostic factors for OS, these populations still had improved CS after 2 years postoperatively.
AB - Introduction: Complete resection of colorectal liver metastasis (CLM) improves long-term survival in colorectal cancer. However, there is limited recent data on conditional survival (CS) as postoperative survival milestones are achieved post-hepatectomy. Methods: A retrospective analysis was performed on the penta-institutional Colorectal Liver Operative Metastasis International Collaborative (COLOMIC), with 906 consecutive CLM hepatectomy cases. CS was calculated using Bayes’ theorem and Kaplan-Meier analysis. Additional CS analyses were performed on additional clinicopathologic risk factors, including colon cancer laterality, KRAS mutation status, and extrahepatic disease. Results: The 5-year CS was 40.6%, 45.3%, 52.8%, and 65.3% at 0, 1, 2, and 3 years postoperatively, with significant improvements each year (p < 0.005). CS was not significantly different between right-sided and left-sided colorectal cancers by 3 years postoperatively. Patients with KRAS mutations had worse CS at all timepoints (p < 0.001). Extrahepatic disease was a poor prognostic factor for OS and CS (p < 0.001). However, CS for patients with KRAS mutations or extrahepatic disease improved significantly as 2-year, postoperative survival was achieved (p < 0.05). Conclusions: Five-year CS after hepatectomy for CLM improved with each passing year of survival postoperatively. Although extrahepatic disease and KRAS mutations are poor prognostic factors for OS, these populations still had improved CS after 2 years postoperatively.
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U2 - 10.1245/s10434-023-13189-w
DO - 10.1245/s10434-023-13189-w
M3 - Article
C2 - 36859704
AN - SCOPUS:85149072952
SN - 1068-9265
VL - 30
SP - 3413
EP - 3422
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 6
ER -