Prognosis and risk factors of different recurrence patterns after hepatectomy for colorectal liver metastasis

Abstract

Abstract: Objective: To study the prognostic differences and risk factors of different recurrence patterns after hepatectomy for colorectal liver metastasis.
Methods: The general data, clinical data and follow-up data of patients with colorectal liver metastasis who underwent hepatectomy in the Department of General Surgery of Peking University Third Hospital from January 2009 to February 2023 were collected. Kaplan-Meier curve was used to analyze the survival differences between different recurrence times and different recurrence sites. The maximally selected test was used to find the optimal cut-off value of recurrence time for distinguishing the survival after recurrence. Logistic regression analysis were used to analyze the risk factors of early recurrence.
Results: A total of 281 patients met the inclusion and exclusion criteria. There were statistically significant differences in mortality and overall survival between patients with and without postoperative recurrence (P=0.001). The optimal cut-off value for distinguishing early and late recurrence was 12 months (P=0.001). There was a statistically significant difference in the post-recurrence survival between patients with early recurrence and late recurrence (P=0.001 1). There was a statistically significant difference in the post-recurrence survival between different recurrence sites (P=0.002 3), and the prognosis of patients with the first recurrence site in the lung was the best. Logistic regression analysis showed that patients with positive lymph node metastasis of primary tumor (OR=2.294, 95%CI:1.171-4.496, P=0.019), preoperative CEA≥5.31 ng/ml (OR=2.160, 95%CI:1.001-4.660, P=0.049 8) and preoperative CA19-9≥ 40.52 U/ml (OR=2.210, 95%CI:1.030-4.741, P=0.042) were at high risk of early recurrence after surgery.
Conclusions: The recurrence within 12 months and extrapulmonary recurrence is associated with poor prognosis. The risk factors for early recurrence include positive lymph node metastasis of primary tumor, preoperative CEA≥5.31 ng/ml and preoperative CA19-9≥ 40.52 U/ml. Patients with related risk factors should be actively reviewed and monitored.

Key words: Colorectal cancer, Liver metastasis, Hepatectomy, Recurrence, Prognosis, Risk factors

Chen Hanwei, Li Lei. Prognosis and risk factors of different recurrence patterns after hepatectomy for colorectal liver metastasis[J]. Electronic Journal of Liver Tumor, 2024, 11(2): 27-32.

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