Prognostic factors for survival in patients with colorectal liver metastases: experience of a single brazilian cancer center


Autoria(s): Ribeiro, Héber Salvador de Castro; Stevanato-Filho, Paulo Roberto; Costa Jr., Wilson Luiz da; Diniz, Alessandro Landskron; Herman, Paulo; Coimbra, Felipe José Fernández
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

04/11/2013

04/11/2013

2012

Resumo

CONTEXT: Liver metastases are a common event in the clinical outcome of patients with colorectal cancer and account for 2/3 of deaths from this disease. There is considerable controversy among the data in the literature regarding the results of surgical treatment and prognostic factors of survival, and no analysis have been done in a large cohort of patients in Brazil. OBJECTIVES: To characterize the results of surgical treatment of patients with colorectal liver metastases, and to establish prognostic factors of survival in a Brazilian population. METHOD: This was a retrospective study of patients undergoing liver resection for colorectal metastases in a tertiary cancer hospital from 1998 to 2009. We analyzed epidemiologic variables and the clinical characteristics of primary tumors, metastatic disease and its treatment, surgical procedures and follow-up, and survival results. Survival analyzes were done by the Kaplan-Meier method and the log-rank test was applied to determine the influence of variables on overall and disease-free survival. All variables associated with survival with P<0.20 in univariate analysis, were included in multivariate analysis using a Cox proportional hazard regression model. RESULTS: During the period analyzed, 209 procedures were performed on 170 patients. Postope-rative mortality in 90 days was 2.9% and 5-year overall survival was 64.9%. Its independent prognostic factors were the presence of extrahepatic disease at diagnosis of liver metastases, bilateral nodules and the occurrence of major complications after liver surgery. The estimated 5-year disease-free survival was 39.1% and its prognostic factors included R1 resection, extrahepatic disease, bilateral nodules, lymph node involvement in the primary tumor and primary tumors located in the rectum. CONCLUSION: Liver resection for colorectal metastases is safe and effective and the analysis of prognostic factors of survival in a large cohort of Brazilian patients showed similar results to those pointed in international series. The occurrence of major postoperative complications appears to be able to compromise overall survival and further investigation in needed in this topic.

Identificador

Arq. Gastroenterol.,v.49,n.4,p.266-272,2012

0004-2803

http://www.producao.usp.br/handle/BDPI/38084

10.1590/S0004-28032012000400007

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032012000400007&lng=en&nrm=iso&tlng=en

http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0004-28032012000400007&lng=en&nrm=iso&tlng=en

http://www.scielo.br/scielo.php?script=sci_pdf&pid=S0004-28032012000400007&lng=en&nrm=iso&tlng=en

Idioma(s)

eng

Publicador

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED

Relação

Arquivos de Gastroenterologia

Direitos

openAccess

Palavras-Chave #Colorectal neoplasm #Liver neoplasms, secondary #Hepatectomy #Prognosis #Neoplasias colorretais #Neoplasias hepáticas, secundárias #Hepatectomia #Prognóstico
Tipo

article

original article