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Titolo:
Patterns of recurrence after resection of colorectal liver metastases: Prediction by models of outcome analysis
Autore:
Lise, M; Bacchetti, S; Da Pian, P; Nitti, D; Pilati, P;
Indirizzi:
Univ Padua, Sezione Clin Chirurg, Dipartimento Sci Oncol & Chirurg, I-35128 Padua, Italy Univ Padua Padua Italy I-35128 Sci Oncol & Chirurg, I-35128 Padua, Italy
Titolo Testata:
WORLD JOURNAL OF SURGERY
fascicolo: 5, volume: 25, anno: 2001,
pagine: 638 - 644
SICI:
0364-2313(200105)25:5<638:PORARO>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEPATIC ARTERIAL INFUSION; PERIOPERATIVE BLOOD-TRANSFUSION; PROGNOSTIC SCORING SYSTEM; DISEASE-FREE SURVIVAL; CARCINOMA METASTASES; SURGICAL MARGIN; RISK-FACTORS; CANCER; DETERMINANTS; CHEMOTHERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
49
Recensione:
Indirizzi per estratti:
Indirizzo: Lise, M Univ Padua, Sezione Clin Chirurg, Dipartimento Sci Oncol & Chirurg, Via Giustiniani 2, I-35128 Padua, Italy Univ Padua Via Giustiniani 2 Padua Italy I-35128 128 Padua, Italy
Citazione:
M. Lise et al., "Patterns of recurrence after resection of colorectal liver metastases: Prediction by models of outcome analysis", WORLD J SUR, 25(5), 2001, pp. 638-644

Abstract

Various series have reported similar survival and recurrence rates after resection of colorectal liver metastases (CRLM). If outcomes were predictable, indications For surgery could be improved. This hypothesis was tested in135 consecutive patients with CRLM who underwent "curative" resection from1977 to 1997. Among the 132 patients available for follow-up, three groupswere identified on the basis of outcome: (1) survival of mure than 5 yearsdisease-free (n = 32; 24%): (2) diffuse recurrences within the first 6 months (n = 24; 18%); and (3) discrete recurrences for which reresection was performed (n = 16: 124). As our results are similar to those reported in theliterature, we assumed that about 50% of patients with resectable lesions have recognizable patterns of recurrence. AL multivariate analysis, factorssignificant for disease-free survival (DFS) were the percentage of liver invasion, metastases to lymph nodes at the primary site, number of metastases, preoperative glutamic pyruvic transaminase (GPT) level, and type of liver resection. On the basis of the relative risk (RR) expressed by significant prognostic factors, a score model was developed, and three prognostic groups were defined: Group A, with the best prognostic score, included 23 of 32 (72%) patients who survived more than 5 years, and that with the worst prognostic score (group C) included 22 of 24 (92%) patients with early diffuse recurrences. Extreme (especially unfavorable) outcomes can therefore be predicted. By using improved models of outcome analysis, many patients couldbe spared surgery as first-line treatment, and stratification criteria could be worked out for future trials.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 01:30:02