Surgical strategy for repeated metastasectomy for advanced colorectal cancer with synchronous liver metastases.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-09-09 DOI:10.1007/s00595-025-03125-8

Tetsuro Kawazoe, Ryota Nakanishi, Koji Ando, Yoko Zaitsu, Kensuke Kudou, Tomonori Nakanoko, Shinji Itoh, Eiji Oki, Tomoharu Yoshizumi

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引用次数: 0

Abstract

Purpose: Liver metastases from colorectal cancer (CRLM) are a major determinant of the prognosis of metastatic colorectal cancer. Although curative resection is recommended for resectable CRLM, recurrence remains a challenge and the criteria for patient selection and repeat resection are still unclear. We conducted this study to evaluate the outcomes of metastatic lesion resection with curative intent (R0 resection), to identify the factors associated with recurrence, and to establish the feasibility of repeat metastasectomy.

Methods: This single-center retrospective study analyzed 135 patients with synchronous CRLM, who underwent surgical resection or received chemotherapy between January, 2013 and March, 2023.

Results: R0 resection was achieved in 62 (45.9%), with a median recurrence-free survival of 12.3 months. Recurrence developed in 50 (80.6%) of these patients and 28 underwent repeat R0 resection. Initial R0 resection was associated with significantly improved overall survival (OS; hazard ratio [HR], 0.12; p < 0.01) and repeat R0 resection after recurrence improved survival further (HR, 0.32; p = 0.019). Conversion surgery, performed in 42 of 114 patients (36.8%) initially treated with chemotherapy, was significantly associated with the absence of extrahepatic metastases and H1 liver metastases.

Conclusions: These findings highlight the importance of individualized treatment strategies for optimizing CRLM outcomes.

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伴有同步肝转移的晚期结直肠癌重复转移切除术的手术策略。

目的：结直肠癌肝转移是影响结直肠癌预后的重要因素。虽然建议对可切除的CRLM进行根治性切除，但复发仍然是一个挑战，患者选择和重复切除的标准仍然不清楚。我们进行了这项研究，以评估转移灶治疗目的切除（R0切除）的结果，确定与复发相关的因素，并确定重复转移切除术的可行性。方法：本单中心回顾性研究分析了2013年1月至2023年3月期间接受手术切除或化疗的135例同步CRLM患者。结果：62例（45.9%）患者实现了R0切除，中位无复发生存期为12.3个月。这些患者中有50例（80.6%）出现复发，28例进行了重复R0切除术。初始R0切除与总生存率（OS）显著提高相关；风险比[HR]， 0.12； p结论：这些发现强调了个性化治疗策略对优化CRLM结果的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.