Surgical technique and systemic inflammation influences long-term disease-free survival following hepatic resection for colorectal metastasis.
J Surg Oncol
; 98(5): 371-6, 2008 Oct 01.
Article
em En
| MEDLINE
| ID: mdl-18646038
ABSTRACT
BACKGROUND:
To date, there is limited data available on prognostic factors that influence long-term disease-free survival following hepatic resection for colorectal liver metastasis (CRLM). The aim of the study was to identify prognostic factors that were associated with long-term disease-free survival (>5 years) following resection for CRLM.METHODS:
Patients undergoing resection for CRLM from January 1993 to March 2007 were identified from the hepatobiliary database. Data analyzed included demographics, laboratory results, operative findings and histopathological data.RESULTS:
Seven hundred five curative primary hepatic resections were performed, of which 434 patients developed disease recurrence within 5 years and 67 patients were disease-free more than 5 years. There was a significant association between systemic inflammatory response (raised neutrophil to lymphocyte ratio and/or C-reactive protein), blood transfusion, >2 tumors, bilobar disease and resection margin involvement with developing recurrence during the follow-up period. On multivariate analysis, three independent predictors for recurrent disease within the 5-year follow-up were identified pre-operative inflammatory response; blood transfusion requirement; and status of resection margin.CONCLUSION:
Absence of a systemic inflammatory response and surgical technique to minimize transfusion requirements and obtain a R0 resection margin, are associated with long-term disease-free survival.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Hepatectomia
/
Inflamação
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Neoplasias Hepáticas
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Recidiva Local de Neoplasia
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article