Multiple colorectal liver metastases resection can offer long-term survival: The concept of a chronic neoplastic disease

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art_DUMARCO_Multiple_colorectal_liver_metastases_resection_can_offer_longterm_2023.PDF (601.88 KB)
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4
Tipo de produção
article
Data de publicação
2023
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Scopus
Web of Science
PubMed
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MOSBY-ELSEVIER
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Citação
SURGERY, v.173, n.4, p.983-990, 2023
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Unidades Organizacionais
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Resumo
Background: Resection for colorectal liver metastases has evolved significantly and, currently, there are no limits to the number of resected nodules. This study aimed to evaluate the outcomes and prognostic factors after liver resection for patients with >= 4 colorectal liver metastases, emphasizing long-term survival. Methods: The study population consisted of 137 patients with >= 4 colorectal liver metastases out of a total of 597 patients with colorectal liver metastases who underwent curative intent liver resection from January 2010 to July 2019 in a single hepatobiliary center. Results: The probability of overall and disease-free survival at 1, 3, and 5 years was 90.8%, 64.5%, 40.6%, and 37.7%, 19.3%, 18.1%, respectively. In a multivariate analysis for overall survival, the size of the largest metastatic nodule was the only unfavorable factor (P =.001). For disease-free survival, complete pathological response was a favorable factor (P =.04), and the following were negative factors: number of nodules >= 7 (P =.034), radiofrequency ablation during surgery (P =.04), positive primary tumor lymph nodes (P =.034), R1 resection (P =.011), and preoperative carcinoembryonic antigen >20 ng/mL (P =.015). After the first and second years of follow-up, 59 patients (45.3%) and 45 patients (34.6%), respectively, were not receiving chemotherapy. After 5 years of follow-up, 21 (16.1%) multimetastatic patients were chemotherapy-free. Conclusion: A significant number of patients with multiple colorectal liver metastases will present long-term survival and should not be denied surgery. The long-term survival rates, even in the presence of recurrence, characterize a chronic neoplastic disease.
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https://observatorio.fm.usp.br/handle/OPI/54684
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/02
Artigos e Materiais de Revistas Científicas - LIM/37
Artigos e Materiais de Revistas Científicas - ODS/03