1. High resection rates of colorectal liver metastases after standardized follow-up and multimodal management: an outcome study within the COLOFOL trial
- Author
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Peter Scherman, Pernilla Hansdotter, Erik Holmberg, Frank Viborg Mortensen, Sune H. Petersen, Magnus Rizell, Peter Naredi, Ingvar Syk, Peer Wille-Jørgensen, Erzsébet Horváth-Puhó, Søren Laurberg, Lars Påhlman, Andrew Renehan, Kenneth Smedh, Henrik Christensen, Jesper Dan Nielsen, Per Jess, Allan Gorm Pedersen, Mogens Rørbæk Madsen, Per Vadgaard Andersen, Erling Østergaard, Pernilla Hansdotter Andersson, Jonas Bengtsson, Mats Bragmark, Pamela Buchwald, Monika Egenvall, Parastau Farahnak, Joakim Folkesson, Michael Goldinger, Rolf Heuman, Kenneth Lindberg, Anna Martling, Pia Näsvall, Johan Ottosson, Birger Sandzén, and Carlos Barberousse
- Subjects
Hepatectomy/adverse effects ,Liver Neoplasms/surgery ,Colorectal Neoplasms/pathology ,Hepatology ,Outcome Assessment, Health Care ,Gastroenterology ,Humans ,Neoplasm Recurrence, Local ,Follow-Up Studies ,Retrospective Studies - Abstract
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. 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.
- Published
- 2023
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